Kinetic and Clinical Studies of β2Microglobulin in Continuous Ambulatory Peritoneal Dialysis: Influence of Renal and Enhanced Peritoneal Clearances Using Glucose Polymer.

A risk of β2microglobulin (β2-M)-associated amyloidosis in long-term CAPD patients has been recognised. We examined the kinetics of β2-M and potential clinical manifestations of amyloidosis in patients wellestablished on CAPD for 1–76 months (mean±SEM; 16.4±14 months). In 57 patients, serum β2-M concentration was elevated to 30±1.8 (mean±SEM, mg\1) and correlated positively with the duration on CAPD. In 18 patients studied with variable degrees of residual renal function, serum β2-M concentration increased with declining renal function; this was most marked when the creatinine clearance was less than 1 ml\min. Using an isosmolar solution (302±1.3mOsm\kg) containing 5% glucose polymer (9.4 mmol\1; MW 16 800), the transperitoneal elimination of β2-M was significantly enhanced (1.6 times) compared to conventional 1.36% glucose solution, but without a detectable change in serum concentrations during a 6-h study. No significant difference was found between the estimated minimum volume of distribution of β2-M in CAPD and haemodialysis patients. Symptomatic. amyloid-associated disease was absent in patients in this study, and may be attributed to the short duration of dialysis. [ABSTRACT FROM PUBLISHER]