Relative importance of residual renal function and convection in determining beta-2-microglobulin levels in high-flux haemodialysis and on-line haemodiafiltration

Blood Purif. 2007;25(3):295-302. doi: 10.1159/000104870. Epub 2007 Jul 2.


Background: Convective blood purification improves beta(2)-microglobulin (beta(2)M) removal and may delay the onset of dialysis-related amyloidosis. We assessed the differential effects of high-flux haemodialysis (HD) and on-line haemodiafiltration (HDF) on plasma beta(2)M levels, given the enhanced convective capability of HDF.

Methods: We measured pre-dialysis beta(2)M levels in 297 patients in a programme employing both high-flux HD and HDF, then analysed the relationship of beta(2)M to modality and other variables.

Results: Independent determinants of plasma beta(2)M levels were residual renal function, age, HD vintage, and C-reactive protein load, but not the patient's predominant modality (high-flux HD or HDF). Patients with KRU levels <0.5 ml/min had significantly higher beta(2)M levels than patients with KRU between 0.5 and 1 ml/min.

Conclusions: Residual renal function is of overriding importance as a determinant of beta(2)M levels in HD patients and may supersede enhanced convective clearance by HDF. Beneficial effects extend to very low levels of residual renal function.

MeSH terms

  • Adult
  • Aged
  • Amyloidosis / etiology
  • Amyloidosis / prevention & control
  • C-Reactive Protein / analysis
  • Convection
  • Female
  • Hemodiafiltration* / adverse effects
  • Hemodiafiltration* / methods
  • Humans
  • Kidney / physiopathology*
  • Kidney Failure, Chronic / blood
  • Kidney Failure, Chronic / therapy
  • Kidney Function Tests
  • Male
  • Membranes, Artificial
  • Metabolic Clearance Rate
  • Middle Aged
  • Polymers
  • Renal Dialysis* / adverse effects
  • Renal Dialysis* / methods
  • Rheology
  • Sulfones
  • Time Factors
  • Urea / blood
  • beta 2-Microglobulin / analysis*


  • Membranes, Artificial
  • Polymers
  • Sulfones
  • beta 2-Microglobulin
  • polysulfone P 1700
  • Urea
  • C-Reactive Protein