Background. Recently. invasive fungal infections have increased significant
ly because of the growing number of immunocompromised hosts. The measuremen
t of plasma (1 -->3)-beta -D-glucan has been proposed as a useful diagnosti
c tool for deep mycosis. In this study. we analyzed the alteration of the p
lasma (1 -->3)-beta -D-glucan concentration by using different kinds of hem
odialvsis (HD) membranes in end-stage renal disease (ESRD) patients and est
imated its half-life.
Methods. Twenty-seven patients with ESRD without known fungal infections (w
ith a median age of 66 years old) were enrolled in this study. Cellulose tr
iacetate (CTA) membrane, cellulose (Cu) membrane, and polymethyl methacryla
te (PMMA) membrane were used in three consecutive initiations of HD and pla
sma (1 -->3)-beta -D-glucan concentration was measured before and after eac
h HD session.
Results. The level did not change between before and after HD when CTA and
PMMA membranes were used. In contrast, the plasma (1 -->3)-beta -D-glucan l
evel increased greatly after HD using the Cu membrane (from 9.4 to 332 pg/m
L in median). Hypothesizing that the plasma (1 -->3)-beta -D-glucan level d
eclines exponentially. its median half-life is estimated at 20 hours, which
is not affected by hepatic or renal function.
Conclusions. Because the plasma (1 -->3)-beta -D-glucan level increases dra
matically after HD using the Cu membrane. dialyzers with Cu membrane should
be avoided for HD in patients with suspected deep mycosis. The measurement
of plasma (1 -->3)-beta -D-glucan is also useful For the patients with hep
atic or renal Failure.