The Effect of Hemodiafiltration Versus High Flux Dialysis on Free Light Chains Reduction and Its Relation to Albumin Loss

Abstract

Uremic toxins are solutes that accumulate in human body in kidney impairment and cause harmful biological effects. They are classified according to molecular weight into; small-water soluble, medium sized and protein bound solutes. Recently, middle-sized molecules have been associated with chronic inflammatory conditions, dialysis related complications and cardiovascular complications. Free light chains are classified as middle-sized molecules, (Kappa: 25KDa, Lambda 45KDa), their level increase markedly in CKD and ESRD patients. They are associated with neutrophils dysfunction, vascular calcification, and chronic inflammatory state. Most hemodialysis techniques have the capacity of removal of small water-soluble molecules but have difficulties in removal of FLCs. Convective techniques and high permeable dialyzers remove FLCs efficiently but with significant transmembrane albumin loss.