Abstract
In recent years, removal of β2microglobulin (β2MG) by the hemoadsorption method has been advocated as a newer promising therapy for dialysis-related amyloidosis. In this article we report maintenance-hemodialyzed female patient with hemodialysis-related amyloidosis who repeatedly showed worsening of renal anemia after application of β2MG adsorbent column. Although cardiovascular complications and exacerbations of anemia have previously been noted in an unpublished manufacturer's report, details of the mechanism responsible have not yet been elucidated. Concerning anemia, some possible candidates such as deficiency of vitamin B12, folic acid or carnitine have been raised as a causative factor in previous reports. However, we denied these as determinant in our case. Rather, we considered hemolysis as the most likely cause, because changes in haptoglobin level and reticulocyte count most clearly paralleled worsening of renal anemia. It is obvious that further studies are necessary for safe and effective application of the β2MG adsorbent column to hemodialysisrelated amyloidosis treatment.
