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Beta-2 microglobulin (B2M) is an immune system protein that is found on the surface of all nucleated human cells. B2M is naturally shed from cell surfaces into the plasma, followed by renal excretion. In patients with impaired renal function, B2M will accumulate in organs and tissues leading to significantly reduced life expectancy and quality of life. While current hemodialysis methods have been successful in managing electrolyte as well as small and large molecule disturbances arising in chronic renal failure, they have shown only modest success in managing plasma levels of B2M and similar sized proteins, while sparing important proteins such as albumin. We describe a systematic protein design effort aimed at adding the ability to selectively remove specific, undesired waste proteins such as B2M from the plasma of chronic renal failure patients. A novel nanoparticle built using a tetrahedral protein assembly as a scaffold that presents 12 copies of a B2M-binding nanobody is described. The designed nanoparticle binds specifically to B2M through protein-protein interactions with nanomolar binding affinity (~4.2 nM). Notably, binding to the nanoparticle increases the effective size of B2M by over 50-fold, offering a potential selective avenue for separation based on size. We present data to support the potential utility of such a nanoparticle for removing B2M from plasma by either size-based filtration or by polyvalent binding to a stationary matrix under blood flow conditions. Such applications could address current shortcomings in the management of problematic mid-sized proteins in chronic renal failure patients.
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http://dx.doi.org/10.3390/biom13071122 | DOI Listing |
Zhong Nan Da Xue Xue Bao Yi Xue Ban
May 2025
Nursing Department, Third Xiangya Hospital, Central South University, Changsha 410013.
Objectives: End stage renal disease (ESRD) is a major disease that seriously threatens the health of young people, and kidney transplantation is an effective treatment method to improve its prognosis.Young ESRD patients at a critical stage of life development often face significant physical and psychological challenges while waiting for kidney transplantation. Their psychological state directly affects treatment compliance and transplantation outcomes.
View Article and Find Full Text PDFJ Prim Care Community Health
September 2025
Division of Nephrology, Department of Medicine, National University Hospital, Singapore.
Background: Chronic kidney disease (CKD) management was largely centered around renin-angiotensin-aldosterone system inhibitors (RAASi) optimization, until recent emergence of novel therapeutics. However, slow adoption of guideline-directed therapy leaves patients vulnerable to disease progression. In 2022, a data-driven informatics approach was introduced to track real-time adherence to best practices.
View Article and Find Full Text PDFNan Fang Yi Ke Da Xue Xue Bao
August 2025
Department of Nephrology, First Affiliated Hospital of Guilin Medical University, Guilin 541000, China.
Objectives: To investigate the effect of serum advanced glycation endproducts (AGEs) on stenosis after first autologous arteriovenous fistula (AVF) in patients with end-stage renal disease (ESRD).
Methods: Patients with ESRD undergoing standard native arteriovenous fistula (AVF) for the first time in the Department of Nephrology, Affiliated Hospital of Guilin Medical University from February to June 2022 were prospectively enrolled. The preoperative general data, clinical examination results and ultrasound data of the operated limbs were collected.
Ren Fail
December 2025
Department of Nephrology, The Affiliated Hospital of Qingdao University, Qingdao, China.
Large language models (LLMs) represent a transformative advance in artificial intelligence, with growing potential to impact chronic kidney disease (CKD) management. CKD is a complex, highly prevalent condition requiring multifaceted care and substantial patient engagement. Recent developments in LLMs-including conversational AI, multimodal integration, and autonomous agents-offer novel opportunities to enhance patient education, streamline clinical documentation, and support decision-making across nephrology practice.
View Article and Find Full Text PDFRen Fail
December 2025
Division of Nephrology, Department of Internal Medicine, Bursa Uludag University Faculty of Medicine, Bursa, Turkey.
Peritoneal dialysis (PD) and hemodialysis (HD) are the two primary renal replacement therapies for patients with end-stage renal disease (ESRD). While PD is an effective and convenient modality, long-term use can lead to ultrafiltration failure, recurrent peritonitis, and progressive structural alterations in the peritoneal membrane, necessitating a transition to HD. In recent years, rather than a complete transition, the combined use of PD and HD has emerged as a viable alternative, offering potential advantages for selected patient populations.
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