β2-Microglobulin and Phosphate Clearances Using a Wearable Artificial Kidney: A Pilot Study
Received 14 November 2008; accepted 4 February 2009. published online 20 April 2009.
Background
Additional small-solute clearances during standard thrice-weekly hemodialysis treatments have not improved patient survival. However, these treatments have limited middle-molecule clearances. Thus, newer therapies designed to increase middle-molecule clearances need to be developed and evaluated.
Study Design
Pilot clinical trial to measure β2-microglobulin and phosphate clearances with a wearable hemodialysis device.
Setting & Participants
8 regular hemodialysis patients under the care of a university teaching hospital.
Intervention
Patients were fitted with a wearable hemodialysis device for 4 to 8 hours.
Outcomes
All patients tolerated the treatment.
Results
Average amount of β2-microglobulin removed was 99.8 ± 63.1 mg, with mean clearance of 11.3 ± 2.3 mL/min, and an average of 445.2 ± 326 mg of phosphate was removed, with mean plasma phosphate clearance of 21.7 ± 4.5 mL/min. These clearances compared favorably with mean urea and creatinine plasma clearances (21.8 ± 1.6 and 20.0 ± 0.8 mL/min, respectively).
Limitations
Proof-of-concept preliminary trial. Additional studies are warranted to confirm these positive preliminary data.
Conclusions
This wearable artificial kidney potentially provides effective β2-microglobulin and phosphate clearances and, by analogy, middle-molecule clearances.
3Center for Nephrology, Division of Medicine, Royal Free and University College Hospital Medical School, London, UK
4Divisione de Nefrologia, Ospedale San Bortolo, Vicenza, Italy
Address correspondence to Victor Gura, MD, Associate Clinical Professor of Medicine. UCLA, The Geffen School of Medicine, 9100 Wilshire Blvd, Ste 360W, Beverly Hills, CA 90212
ABSTRACT