Clinical significance of protein adsorbable membranes--Long-term clinical effects and analysis using a proteomic technique

Abstract

Polymethylmethacrylate (PMMA) membranes were first developed in Japan in 1977. Over its 30-year history, use of PMMA has given rise to a new generation of dialysers and continues to evolve. In long-term observation of patients treated with PMMA membranes (BK series), it has been found that serum beta2-microglobulin is maintained at a significantly lower level than in haemodialysis (HD) patients undergoing treatment with conventional cellulosic membranes. Regarding long-term side effects, radiolucent bone cysts (RBC) and carpal tunnel syndrome (CTS) have developed in relatively few patients undergoing HD with PMMA membranes. The profiles of various proteins in the blood of HD patients differ from those in normal subjects. PMMA membranes remove a wide variety of solutes not only via permeation, but also adsorption. Numerous reports have noted that pruritus can be ameliorated with the use of slightly anionic PMMA membranes (BG series). We have been performing proteomic analysis of plasma from HD patients with pruritus. We have confirmed that slightly anionic PMMA membranes can adsorb components with a molecular weight of 160,000 Da, which have stimulatory effect on mast cells from pruritus.

Differences in Bio-incompatibility among Four Biocompatible Dialyzer Membranes Using in Maintenance Hemodialysis Patients

“…It may be more important for β 2 -microglobulin clearance by adsorption than convection in these dialyzer membranes. 19 PMMA membranes have more powerful adsorptive ability than other membranes. [19][20][21] So the low-flux synthetic membranes with higher absorptive ability (PS/PMMA membrane) may have the similar capability to high-flux membranes (PES/CTA membranes) on β 2 -microglobulin removal.…”

“…19 PMMA membranes have more powerful adsorptive ability than other membranes. [19][20][21] So the low-flux synthetic membranes with higher absorptive ability (PS/PMMA membrane) may have the similar capability to high-flux membranes (PES/CTA membranes) on β 2 -microglobulin removal. It is obvious that the possibilities of upto-date polymer chemistry allow for the development of large-pore membranes with different compositions and characteristics.…”

A new polymethylmetacrylate membrane improves the membrane adhesion of blood components and clinical efficacy

“…9). Previous articles have reported the improvements of various clinical symptoms with the conventional PMMA dialyzers [3][4][5][9][10][11][12][13][14][15][16][17][18][19]. Protein adsorption by PMMA membranes is considered one factor associated with these improvements.…”

Advances in Hemodialysis Techniques

“…Synthetic membrane micro porous zeolite silica lite (MFI) has been shown to be quite effective in adsorbing high levels of the protein-bound solute P-cresol [98], which is not eliminated efficiently by conventional HD. Furthermore, the synthetic thick polymethylmethacrylate (PMMA) membranes (30 micron thickness), which have good solute permeability and a high degree of biocompatibility, do have high adsorptive capacity reaching up to 160,000 Dalton [99].…”

“…The use of PMMA membranes has been shown to ameliorate the severity and frequency of pruritis [95] in HD patients due to adsorption of a 160,000 Dalton molecular weight molecule with stimulatory effect on mast cells [100]. PMMA membranes also efficiently adsorb β 2 -M (representative of middle molecules), where they have been shown to improve carpal tunnel syndrome or total joint pain score in HD patients [99]. In addition, patients dialyzed with PMMA membrane have lower need for erythropoietin due to the elimination of an inhibitor of erythropoesis retrieved in the dialysate [101].…”