Application of Cystatin C Reduction Ratio to High-Flux Hemodialysis as an Alternative Indicator of the Clearance of Middle Molecules
The Korean Journal of Internal Medicine
; : 77-81, 2010.
Article
in English
| WPRIM (Western Pacific)
| ID: wpr-10973
Responsible library:
WPRO
ABSTRACT
BACKGROUND/AIMS:
Although high-flux (HF) dialyzers with enhanced membrane permeability are widely used in current hemodialysis (HD) practice, urea kinetic modeling is still being applied to indicate the adequacy of both low-flux (LF) and HF HD. In comparison with urea (molecular weight, 60 Da) and beta2-microglobulin (beta2MG, 12 kDa), cystatin C (CyC, 13 kDa) is a larger molecule that has attractive features as a marker for assessing solute clearance. We postulated that CyC might be an alternative for indicating the clearance of middle molecules (MMs), especially with HF HD.METHODS:
Eighty-nine patients were divided into LF and HF groups. Using single pool urea kinetic modeling, the urea reduction ratio (URR) and equilibrated Kt/Vurea (eKt/Vurea) were calculated. The serum CyC concentrations were measured using particle-enhanced immunonephelometry. As indices of the middle molecular clearance, the reduction ratios of beta2MG and CyC were calculated.RESULTS:
The beta2MG reduction ratio (beta2MGRR) and CyC reduction ratio (CyCRR) were higher in the HF group compared to the LF group. However, the URR and eKt/Vurea did not differ between the two groups. The CyCRR was significantly correlated with the eKt/Vurea and beta2MGRR (r = 0.47 and 0.69, respectively, both p < 0.0001).CONCLUSIONS:
Compared to the LF dialyzer, the HF dialyzer removed CyC and beta2MG more efficiently. Unlike the beta2MGRR, the CyCRR was correlated with the eKt/Vurea and beta2MGRR. This study suggests a role for the CyCRR as an alternative indicator of the removal of MMs.
Full text:
Available
Health context:
Sustainable Health Agenda for the Americas
Health problem:
Goal 9: Noncommunicable diseases and mental health
Database:
WPRIM (Western Pacific)
Main subject:
Urea
/
Uremia
/
Biomarkers
/
Hemodialysis Solutions
/
Case-Control Studies
/
Beta 2-Microglobulin
/
Renal Dialysis
/
Cystatin C
/
Kidney Failure, Chronic
/
Models, Biological
Type of study:
Observational study
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
Language:
English
Journal:
The Korean Journal of Internal Medicine
Year:
2010
Document type:
Article