Ther Apher Dial. 2011 Aug;15(4):394-9. doi: 10.1111/j.1744-9987.2011.00964.x.
Comparison of free light chain removal by four blood purification methods.
Kanayama K, Ohashi A, Hasegawa M, Kondo F, Yamamoto Y, Sasaki M, Hayashi H, Kato M, Hattori R, Yamashita H, Arai J, Ishii J, Emi N, Yuzawa Y.
Source
Department of Nephrology, Fujita Health University School of Medicine, Aichi, Japan.Abstract
Renal
failure is a frequent complication in patients with multiple myeloma.
Immunoglobulin free light chains (FLCs) form casts in the distal
tubules, resulting in renal obstruction, and are also directly toxic to
proximal renal tubules. Removal of FLCs contributes to renal recovery.
High cut-off (HCO) membrane Theralite2100, protein leaking dialyzer
PES210Dα, plasma separator Evacure1A20 and β(2) microglobulin adsorption
column LixelleS-35 were compared in their FLC removal rate. Dialysis
using Theralite2100 or Evacure1A20, diafiltration using PES210Dα and
adsorption using LixelleS-35 were performed in an in vitro circuit. The
highest removal rate was obtained by Theralite2100 dialysis among the
four blood purification methods. Albumin loss was also the greatest in
Theralite2100 dialysis. The removal content of FLCs per 1 g albumin loss
was better in PES210Dα diafiltration. The removal rate of FLCs by
Evacure EC1A-20 dialysis was the third highest. Adsorption of FLCs by
the β(2) microglobulin adsorption column Lixelle S-35 was confirmed. In
conclusion, Theralite2100 dialysis was the best in removal of FLCs.
PES210Dα diafiltration can remove FLCs with smaller loss of albumin.
© 2011 The Authors. Therapeutic Apheresis and Dialysis © 2011 International Society for Apheresis.
© 2011 The Authors. Therapeutic Apheresis and Dialysis © 2011 International Society for Apheresis.
