Red blood cell function and beta 2 microglobulin kinetics during cuprophan hemodialysis: a hypothesis.

The exact role of beta 2microglobulin (beta 2m) in dialysis amyloidosis is yet not known. Local release of beta 2m from the endothelial cells of the lung and other tissues as a consequence of acute-phase activation due to the contact of blood with membranes has still to be considered a possible pathogenetic factor in this syndrome. beta 2m kinetics and decrease of glutathione content in RBC were studied in 41 chronic hemodialysis patients during cuprophan dialysis. The latter test reflects the RBC scavenger function for free oxygen radicals. Only 30% of patients showed a clinically significant increase in beta 2m. The change in beta 2m in this group between the start and 180 minutes, corrected for plasma volume, was 23.1 +/- 3.6% and the change in gluthathione content between the start and 15 minutes was 4.5 +/- 3.4%. In these patients there was a significant correlation between beta 2m production and decrease of gluthathione (R = -0.61, p = 0.0299). It is possible that the production of free oxygen radicals during bioincompatible dialysis leads to cellular toxicity with release of beta 2m which may be prevented to some extent by the scavenger role of RBC.