Abstract: FR-PO0461
Factors Associated with β2-Microglobulin Removal in High-Volume Hemodiafiltration and Expanded Hemodialysis
Session Information
- Dialysis: Hemodiafiltration, Ultrafiltration, Profiling, and Interdialytic Symptoms
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Zuñiga Gonzalez, Erick Yasar, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, CDMX, Mexico
- Quiñonez-Flores, Alejandro, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, CDMX, Mexico
- Mercado Hernández, Yazmin Alejandra, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, CDMX, Mexico
- Del Toro-Cisneros, Noemi, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, CDMX, Mexico
- Vega, Olynka, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, CDMX, Mexico
Background
Beta-2-microglobulin (β2m), is linked to inflammation, immune dysfunction, and cardiovascular risk in hemodialysis. Advanced dialysis methods like hemodiafiltration (HDF) and expanded hemodialysis (HDx) enhance β2m clearance, but factors affecting its removal remain unclear. This study examined in vivo determinants in HDF and HDx patients.
Methods
Patients with urine output <500 mL/day undergoing high-volume HDF (n=28) or HDx (n=20) were studied. Across 257 HDF and 179 HDx sessions, pre/post-dialysis β2m levels were measured. Logistic regression identified predictors of β2m reduction ratio (RRβ2m) >80%, and linear regression assessed factors influencing β2m removal efficiency.
Results
Groups were similar except for age (HDF: 36 vs HDx: 45 years).In the HDF group, convective volume (CV) averaged 26.7 ± 3.8 L/session, blood flow (Qb) 365 ± 19.5 mL/min, dialysate flow (Qd) 447 ± 26 mL/min, session time (ST) 235 ± 17 min, and RRβ2m 84.8 ± 4.9%. In HDx group, Qb 363 ± 19 mL/min, Qd 539 ± 38 mL/min, ST 230 ± 21 min, ultrafiltration volume (UF) 2.1 ± 0.9 L, and RRβ2m 76.6 ± 5.5%. HDF showed higher RRβ2m (84.8% vs 76.6%) and greater likelihood of achieving RRβ2m >80% (OR 15.8, p<0.0001). In HDF, CV positively correlated with RRβ2m, and body weight (BW) was inversely associated. In HDx, BW negatively affected RRβ2m >80%, while ST and UF improved β2m removal. Qb, Qd, and vascular access had no significant effect in either group.[Figure 1]
Conclusion
In HDF, CV is the key driver of β2m clearance; in HDx, ST and UF volume are primary factors. Higher BW reduces clearance efficiency in both. This findings support individualized care in anuric patients.
Table1. Regression analysis for β2-m reduction target and reduction rate in HDF/HDx.