The following is a summary of “Kinetics of β-2-Microglobulin with Hemodiafiltration and High-Flux Hemodialysis,” published in the April 2024 issue of Nephrology by Ward et al.

Researchers conducted a retrospective study examining how hemodiafiltration changes beta-2-microglobulin levels before and during dialysis. 

They tested the kinetic model using data from the HEMO study and patients on high-flux hemodialysis. Four randomized studies comparing hemodiafiltration to hemodialysis were modeled to assess beta-2-microglobulin levels. Measured data was compared using the model predictions to understand the impact of residual kidney function on beta-2-microglobulin.

The results showed that in the HEMO study, beta-2-microglobulin reduction ratios matched with dialyzer clearances of 5.2 and 26 ml/min in low-flux arms, respectively. Pre-dialysis serum beta-2 microglobulin levels were matched with approximately 240 mg/day generation rates. Another study using dialyzers with higher clearance (57±28 ml/min) showed similar model estimates. The model predicted changes in beta-2-microglobulin levels in all four hemodiafiltration vs. hemodialysis studies, with slightly greater decreases predicted in two studies. Residual kidney function had a similar impact on beta-2-microglobulin, as reported in an observational study. The model predicted that post-dilution hemodiafiltration with 25 L/4h replacement fluid would reduce beta-2-microglobulin levels by about 18.2%, similar to the effect of a residual kidney glomerular filtration rate of 1.50 ml/min.

Investigators concluded that the two-pool model was accurate in measuring the values of beta-2-microglobulin reduction and pre-dialysis serum concentration across different hemodiafiltration and hemodialysis treatments.

Source: journals.lww.com/cjasn/abstract/9900/kinetics_of_beta2_microglobulin_with.374.aspx