Abstract:
For decades, beta 2 microglobulin (B2M) has been a subject of great interest in nephrology and other fields such as multiple myeloma. B2M, a 99 amino acid protein, is associated with amyloid deposits in patients undergoing renal replacement therapy (RRT). The source of information is published articles on B2M in chronic renal failure since 1960. We have reviewed literature published since 1960 to date, highlighting the milestones of the role of B2M in chronic kidney disease (CKD) and B2M serum values in patients treated by various RRTs. B2M deposits associated with the disease include carpal tunnel syndrome, spondyloarthropathy, and arthritis of large joints such as the shoulders. The role of RRT in the removal of B2M in CKD is discussed. Recent reports include factors affecting the process of fibrillation and deposition of B2M in tissues. A comparative report of various modalities of treatment on the serum levels of B2M is provided. The presence of significant residual urine output in continuous ambulatory peritoneal dialysis patients may explain why peritoneal dialysis is a modality that is associated with the lowest level of serum B2M. Patients treated with hemodiafiltration or hemodialysis (HD) using high flux dialyzers have lower levels of B2M than those treated by HD with low flux dialyzers. Finally, based on the literature review, an algorithm for RRT using B2M level monitoring and other variables is proposed and needs evaluation in a controlled trial.
摘要:
几十年来,β2微球蛋白(B2M)已成为肾脏病学和其他领域(例如多发性骨髓瘤)中非常感兴趣的主题。B2M,一种99个氨基酸的蛋白质,与接受肾脏替代治疗(RRT)的患者的淀粉样蛋白沉积有关。信息来源是自1960年以来发表的关于B2M在慢性肾衰竭中的文章。我们回顾了自1960年至今发表的文献,强调B2M在慢性肾脏病(CKD)中的作用和B2M在接受各种RRT治疗的患者中的血清值的里程碑。与疾病相关的B2M沉积物包括腕管综合征,脊柱关节病,和肩膀等大关节的关节炎。商量了RRT在CKD中B2M去除中的感化。最近的报道包括影响B2M在组织中的纤颤和沉积过程的因素。提供了B2M血清水平的各种治疗方式的比较报告。连续非卧床腹膜透析患者中存在大量残余尿量,这可能解释了为什么腹膜透析是与血清B2M水平最低相关的方式。使用高通量透析器进行血液透析滤过或血液透析(HD)治疗的患者的B2M水平低于使用低通量透析器进行HD治疗的患者。最后,在文献综述的基础上,提出了一种使用B2M水平监测和其他变量的RRT算法,需要在对照试验中进行评估。