Abstract: TH-PO278
Use of β2-Microglobulin Adsorption Columns for More than 10 Years Contributes to the Maintenance of Physical Activity in Patients on Long-Term Dialysis Who Have Hemodialysis-Related Amyloidosis
Session Information
- Hemodialysis and Frequent Dialysis - 1
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Kazama, Junichiro James, Fukushima Kenritsu Ika Daigaku, Fukushima, Fukushima, Japan
- Yamamoto, Suguru, Niigata Daigaku Ishigaku Sogo Byoin, Niigata, Niigata, Japan
Background
The β2-microglobulin adsorption column (BMC) was developed in the 1990s to prevent the progression of dialysis-related amyloidosis (DRA) by removing β2-microglobulin from blood in conjunction with hemodialysis. However, the long-term effects of its use are still not well understood. We investigated the condition of dialysis patients who have been using BMC for over 10 years.
Methods
We selected maintenance hemodialysis patients in Japan who have been continuously treated with BMC for over 10 years and conducted interviews with patients who provided consent. The study protocol was approved by the Ethics Review Committee of Fukushima Medical University (FMU23-066).
Results
We obtained responses from 59 patients (70.0±7.2 years old, 22 males and 37 females, dialysis history of 38.2±6.0 years, BMC usage period of 15.0±3.9 years) across 35 facilities. Histological evidence of the deposition of Aβ2M amyloid fibrils was confirmed in all of these patients. Among the 59 patients, 38 had symptoms such as pain in the hands or fingers, hand numbness, hand stiffness, shoulder pain, and lower limb numbness before using BMC. Of these 38 patients, 35 (92.1%) reported a reduction in these symptoms. Eighteen patients experienced a recurrence of these symptoms when BMC treatment was interrupted. Eight patients testified that BMC improved symptoms compared to hemodiafiltration (HDF), while no testimonies indicated that HDF improved symptoms compared to BMC. The daily living abilities evaluated by the Eastern Cooperative Oncology Group Performance Status (ECOG) were PS0: 8.6%, PS1: 34.5%, PS2: 46.6%, PS3: 6.9%, and PS4: 3.4%. The proportions of PS0, PS3, and PS4 were lower, and the proportion of PS2 was higher compared to the data of general maintenance dialysis patients with over 30 years of dialysis history in previous reports.
Conclusion
The pain relief effect of BMC in this study was almost at the same level as previously reported. The pain-relieving effect of BMC observed in this study may have contributed to maintaining the motor function of these patients, preventing their progression to PS3 and PS4 over time. Thus, the long-term use of BMC may contribute to the maintenance of physical activity in dialysis patients with DRA.