ヤマモト　スグル   YAMAMOTO Suguru   山本　偉    所属   医学部 医学科（東京女子医科大学病院）    職種   助教
論文種別	原著
言語種別	英語
査読の有無	査読なし
表題	Direct Hemoperfusion with Polymethylmethacrylate for Hemodialysis Patients with Dialysis-related Amyloidosis.
掲載誌名	正式名：Blood purification 略　 称：Blood Purif ISSNコード：14219735/02535068
掲載区分	国外
巻・号・頁	pp.1-16
著者・共著者	Shoko Yamazaki, Daisuke Miyauchi, Atsushi Hashimoto, Takahiro Tanaka, Mototsugu Tanaka, Hisaki Shimada, Yuji Ishii, Koji Matsuo, Akio Kasai, Yutaka Koda, Kokichi Saito, Junichi Hoshino, Shinichi Nishi, Suguru Yamamoto
担当区分	最終著者
発行年月	2025/08/05
概要	Introduction Dialysis-related amyloidosis (DRA) is a serious complication in patients undergoing long-term dialysis that leads to conditions such as carpal tunnel syndrome and destructive spondyloarthropathy. Improved removal of the precursor protein β2-microglobulin (β2-m) is considered an effective treatment strategy for DRA. Polymethylmethacrylate (PMMA) membranes have the capacity to adsorb β2-m in dialysis filters, suggesting that direct hemoperfusion with PMMA in addition to standard dialysis may enhance β2-m removal. Methods This prospective cohort study included 10 patients undergoing hemodialysis, who were diagnosed with DRA. The participants were treated with dialysis filter alone during Visit 1, both standard dialysis filter and PMMA cartridges (FT-75, volume 75 cm³) during Visits 2-4, and FT-145 PMMA cartridges (volume 145 cm³) during Visits 5-7. The removal rates and clearances of β2-m were quantified. We also assessed the removal of α1-microglobulin (α1-m), matrix metalloproteinase-3 (MMP-3), interleukin-6 (IL-6), and tumor necrosis factor-a (TNF-α), which may be associated with DRA symptoms. Results PMMA cartridge had increased β2-m removal rates compared to dialysis filter alone for treatment duration of 240 min. Similarly, the removal rates of α1-m and MMP-3 were higher with PMMA cartridges than with dialysis filter alone. β2-m, α1-m, and MMP-3 clearance improved with the addition of PMMA cartridges, depending on the cartridge size. The removal rates of IL-6 and TNF-α were higher with PMMA cartridges than with dialysis filter alone at 30 min, but not at 240 min . Conclusion Direct hemoperfusion with PMMA is an effective method for removing β2-m in hemodialysis patients with DRA. Beneficial effects were also observed for the removal of α1-m and MMP-3. Further research is required to evaluate the long-term efficacy of this approach in managing DRA.
DOI	10.1159/000546771
PMID	40763719