Table 4.
Other extracorporeal techniques can be available to reduce FLCs.
| Reference | Design | Sample size | Age (years) | Male (%) | Extracorporeal techniques | FLC concentration at baseline (mg/L) | Serum creatinine at baseline (μmol/L) | Hemodialysis procedure | Reduction of κ FLC | Reduction of λ FLC |
|---|---|---|---|---|---|---|---|---|---|---|
| Santoro et al., 2013 (64) | Pilot study/ Single-center |
7 | 77 | 14.3 | PMMA | 3,648 | NA | 4 h/session | 1 PMMA
a
27.7% 2 PMMA b 33.1% |
1 PMMA
a
15.2% 2 PMMA b 53.1% |
| Fabbrini et al., 2013 (26) | Retrospective/cohort/ Multi-center |
10 | NA | NA | PMMA | 1 PMMA 6,538 2 PMMA 7,925 |
NA | 4 h/session | 1 PMMA
a
22.3% 2 PMMA b 31.0% |
1 PMMA
a
21.0% 2 PMMA b 53.1% |
| Sens et al., 2017 (65) | Retrospective/cohort/ Single-center |
17 | 62 | 47.1 | PMMA | 4,220 | 485 | Six 6-h sessions a week for a maximum of 3 weeks | NA | NA |
| Pendón-Ruiz et al., 2013 (66) | Single-center | 3 | 63 | 33.3 | Supra-HFR | κ 1,873.6 λ 160.4 |
NA | 2 cases with three 4-h sessions a week and 1 case initially with 3-h session a day then a progressive reduction of sessions | 53.8%–63.4% per session c | 38% per session c |
| Pasquali et al., 2015 (24) | Single-center | 4 | 63 | 25 | Supra-HFR | 10,145 | 715.7 | 4 h/session for 8 consecutive days and then every 2 days | 4.9–15.3ml/min c | 3.2–11.5 ml/min c |
| Menè et al., 2018 (67) | Pilot study/ Single-center |
6 | 61 | 50 | Supra-HFR | 6,910 | 972.4 | 5 consecutive sessions on alternate days, the first 2 sessions lasted 3 h and 4 h for the rest of 3 sessions | 84.01% | 69.3% |
| Li et al., 2018 (68) | Single-center | 3 | NA | NA | Supra-HFR | 1,130 | NA | Three 3.5-h sessions a week | NA | 32.2%–49.5% |
| Pendón-Ruiz et al., 2020 (69) | Observational/Single-center | 9 | 72 | 44.4 | Supra-HFR | κ 11,200 λ 1,313 |
750 | The first two sessions last 2.5 h and 3 h, respectively; the remaining sessions last 4 h three times a week | 57.6% | 33.5% |
| Cazorla et al., 2020 (70) | Single-center | 3 | 72 | 66.7 | MCO-HD | 14,300 | 415.5 | 6 h/session | 44.8% per session c | NA |
Abbreviations: NA, not available or could not obtain all of the participants’ detailed information; FLCs, free light chains; PMMA, polymethylmethacrylate; Supra-HFR, hemodiafiltration with ultrafiltrate regeneration by adsorption in resin; MCO-HD, medium-cutoff hemodialysis.
Age, FLC concentration, and serum creatinine are presented as the mean or median.
a
Data show that only one PMMA membrane was adopted in hemodialysis.
b
Data show replacement of the PMMA membrane at the midpoint of hemodialysis.
c
Data present the trend of FLC reduction.