الفهرس | Only 14 pages are availabe for public view |
Abstract 93 SUMMARY AND CONCLUSION Patients on maintenance long term haemodialysis frequently develop many symptoms affecting different organs of the body. One of them that affect different joints & soft tissues is due to deposition of amyloid in the synovium of these joints & bones. This amyloid is a new form of protein that is homologus to 82-microglobulin. In the present work we measured the B2-microglobulin level, creatinine, and urea in 35 patients with chronic renal failure from the outpatient clinic of nephrology hospital (Mansoura University) & 10 normal subjects as a control. The patients were grouped according to the cause of renal failure into 3 groups: renal failure with hypertension, renal failure with schistosomiasis, and the third group caused by miscellaneous causes. The plasma 82- microglobulin was estimated before and immediately after haemodialysis trying to find the effect of dialysis on the level of B2-microglobulin by the use of immunometric assay procedure and gamma counter for counting results. We subdivided each group into another two groups according to the method of dialysis with and without ultrafiltration. The membrane of haemodialysis used was cuprophane- membrane in all methods. In our results there were highly 94 significantly increase in the level of B2-microglobulin in all patients before dialysis which were not correlated With the increase in creatinine, urea level and duration or causes of renal failure. However on estimation of B2- microglobulin after haemodialysis, there was non significant slight decrease in hypertension and schistosomiasis groups using haemodialysis with ultrafiltration, and in the same two groups but using haemodialysis without ultrafiltration, the level of 82-microglobulin increased but this increase was also non significant. In the third group due to miscellaneous causes, showed slight non significant increase using haemodialysis with or without ultrafiltration. So we can conclude from the present study that elimination of sufficient amount of B2-micrOglobulin were affected by: a large molecular weight of B2-microglobulin, the chemical structure of the dialyzer it self, the dialyzer surface area and volume-controlled dialysis using high flux membrane. So cuprophane membrane used in our work although it is effective in decreasing creatinine and urea levels has no or very minimal effect when used with ultrafiltration in lowering B2-microglobulin level, so it is not the first choice of membranes in the treatment of haemodialyzed patient from these complication, also haemodiafiltration with non cellulosic membranes might be the method of choice for prevention and treatment of 82-microglobulin deposition. |