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Volume 13
Issue 4
10.3390/toxins13040255
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Article

Optical Method and Biochemical Source for the Assessment of the Middle-Molecule Uremic Toxin β2-Microglobulin in Spent Dialysate

by
Joosep Paats
1,*,
Annika Adoberg
2,
Jürgen Arund
1,
Ivo Fridolin
1,
Kai Lauri
1,3,
Liisi Leis
2,
Merike Luman
1,2 and
Risto Tanner
1
1
Department of Health Technologies, Tallinn University of Technology, 19086 Tallinn, Estonia
2
Centre of Nephrology, North Estonia Medical Centre, 13419 Tallinn, Estonia
3
SYNLAB Eesti OÜ, 10138 Tallinn, Estonia
*
Author to whom correspondence should be addressed.
Toxins 2021, 13(4), 255; https://doi.org/10.3390/toxins13040255
Submission received: 12 February 2021 / Revised: 23 March 2021 / Accepted: 29 March 2021 / Published: 31 March 2021
(This article belongs to the Section Uremic Toxins)
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Abstract

Optical monitoring of spent dialysate has been used to estimate the removal of water-soluble low molecular weight as well as protein-bound uremic toxins from the blood of end stage kidney disease (ESKD) patients. The aim of this work was to develop an optical method to estimate the removal of β2-microglobulin (β2M), a marker of middle molecule (MM) uremic toxins, during hemodialysis (HD) treatment. Ultraviolet (UV) and fluorescence spectra of dialysate samples were recorded from 88 dialysis sessions of 22 ESKD patients, receiving four different settings of dialysis treatments. Stepwise regression was used to obtain the best model for the assessment of β2M concentration in the spent dialysate. The correlation coefficient 0.958 and an accuracy of 0.000 ± 0.304 mg/L was achieved between laboratory and optically estimated β2M concentrations in spent dialysate for the entire cohort. Optically and laboratory estimated reduction ratio (RR) and total removed solute (TRS) of β2M were not statistically different (p > 0.35). Dialytic elimination of MM uremic toxin β2M can be followed optically during dialysis treatment of ESKD patients. The main contributors to the optical signal of the MM fraction in the spent dialysate were provisionally identified as tryptophan (Trp) in small peptides and proteins, and advanced glycation end-products.
Keywords: β2-microglobulin; hemodialysis; dialysis adequacy; middle molecule uremic toxins; optical monitoring; ultraviolet absorbance; fluorescence β2-microglobulin; hemodialysis; dialysis adequacy; middle molecule uremic toxins; optical monitoring; ultraviolet absorbance; fluorescence

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MDPI and ACS Style

Paats, J.; Adoberg, A.; Arund, J.; Fridolin, I.; Lauri, K.; Leis, L.; Luman, M.; Tanner, R. Optical Method and Biochemical Source for the Assessment of the Middle-Molecule Uremic Toxin β2-Microglobulin in Spent Dialysate. Toxins 2021, 13, 255. https://doi.org/10.3390/toxins13040255

AMA Style

Paats J, Adoberg A, Arund J, Fridolin I, Lauri K, Leis L, Luman M, Tanner R. Optical Method and Biochemical Source for the Assessment of the Middle-Molecule Uremic Toxin β2-Microglobulin in Spent Dialysate. Toxins. 2021; 13(4):255. https://doi.org/10.3390/toxins13040255

Chicago/Turabian Style

Paats, Joosep, Annika Adoberg, Jürgen Arund, Ivo Fridolin, Kai Lauri, Liisi Leis, Merike Luman, and Risto Tanner. 2021. "Optical Method and Biochemical Source for the Assessment of the Middle-Molecule Uremic Toxin β2-Microglobulin in Spent Dialysate" Toxins 13, no. 4: 255. https://doi.org/10.3390/toxins13040255

APA Style

Paats, J., Adoberg, A., Arund, J., Fridolin, I., Lauri, K., Leis, L., Luman, M., & Tanner, R. (2021). Optical Method and Biochemical Source for the Assessment of the Middle-Molecule Uremic Toxin β2-Microglobulin in Spent Dialysate. Toxins, 13(4), 255. https://doi.org/10.3390/toxins13040255

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