Beta-2 microglobulin clearance in high-flux dialysis and convective dialysis modalities: a meta-analysis of published studies
| Autor: | Yue-Harn Ng, Ahmed Alaini, Thomas D. Nolin, Gregory S. Trietley, Zhi Xu, Rocio Figueroa, Christos Argyropoulos, Maria-Eleni Roumelioti, Mark Unruh |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment 030232 urology & nephrology Urology Hemodiafiltration 030204 cardiovascular system & hematology Convection law.invention Diffusion 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Renal Dialysis Dialysis Solutions Hemofiltration medicine Humans Dialysis Whole blood Randomized Controlled Trials as Topic Transplantation Beta-2 microglobulin business.industry Blood flow Confidence interval Nephrology Kidney Failure Chronic Hemodialysis business beta 2-Microglobulin |
| Zdroj: | Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association. 33(6) |
| ISSN: | 1460-2385 |
| Popis: | Background Recent meta-analyses suggest that higher removal of beta-2 microglobulin (β2M) with either high-flux (HFD) dialysis or hemodiafiltration (HDF) may be associated with decreased total and cardiovascular mortality in dialysis patients. However, there are limited data about the performance of high flux dialyzers and/or convective therapies in removing β2M. Methods This is a random effects meta-analysis and meta-regression of data extracted from randomized controlled trials and observational studies in hemodialysis, hemofiltration and HDF regarding the efficiency of high flux dialyzers to remove β2M. Studies were searched using ProQuest in SCOPUS, EMBASE and MEDLINE. Results We included 69 studies from 1 January 2001 to 12 June 2017 on 1879 patients with 6771 available measurements. Average β2M clearance was 48.75 mL/min [95% confidence interval (CI) 42.50-55.21] for conventional HF dialysis, and 87.06 mL/min (95% CI 75.08-99.03) for convective therapies (hemofiltration and HDF) with substantial heterogeneity among studies [P (Q) ≤ 0.001]. In multivariable meta-regression analyses, we found significantly higher β2M clearance for polyarylethersulfone dialyzers when used for HFD and polysulfone membranes in convective therapies. However, the mass of β2M removed into the dialysate did not depend on membrane material. Adjusted dialysate-side (-22.279, 95% CI -9.8 to -34.757, P |
| Databáze: | OpenAIRE |
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