Association Between Plasma Beta-2 Microglobulin Level and Cardiac Performance in Patients With Chronic Kidney Disease

Abstract

Background:Beta-2 microglobulin (B2M) is considered as a surrogate marker for middle molecule uremic toxins and a key component in dialysis-related amyloidosis. However, few studies have evaluated role of B2M in patients with chronic kidney disease (CKD).Objectives:The purpose of this study was to evaluate the association of plasma B2M level with some metabolic and cardiac performance factors in patients with CKD.Patients and Methods:In this case-control study, we measured plasma B2M level in 86 patients with different stages of CKD and 78 age- and sex-matched individuals, as healthy control group. Then we investigated the association between plasma B2M level and left ventricular hypertrophy, ejection fraction (EF), and left ventricular end-diastolic diameter (LVEDD) in echocardiography and some inflammatory and metabolic factors in patients with CKD.Results:Mean plasma B2M level was significantly higher in patients with CKD than in control group (P < 0.001). It was directly correlated with serum C-reactive protein (r = 0.167, P < 0.001), phosphate (r = 0.112, P < 0.001) levels, and left ventricular mass index (r = 0.438, P < 0.001) and LVEDD (r = 0.275, P < 0.001) in echocardiography. It was also inversely correlated with glomerular filtration rate (r = -0.033, P < 0.001), albumin (r = -0.521, P < 0.001), hemoglobin (r = -0.748, P < 0.001), and EF (r = -0.625, P < 0.001).Conclusions:Our findings suggested that plasma B2M level is inversely associated with GFR and EF and directly correlated with some metabolic and cardiac performance factors.

Associations among Serum Beta 2 Microglobulin, Malnutrition, Inflammation, and Advanced Cardiovascular Event in Patients with Chronic Kidney Disease

“…Nevertheless, the association between serum B2M and MIA syndrome had not been well investigated. As previous studies, B2M was associated with stroke, cardiac performance, and CVEs . Besides, B2M was also associated with inflammation , which played an important role in pathophysiology of MIA syndrome .…”

“…Elevated B2M had been observed in malignancy, renal, immunodeficiency, and autoimmune disease (8)(9)(10). B2M was associated with cardiac performance and mortality in those with CKD and those on maintenance hemodialysis (11)(12)(13). It was also a thrombotic marker for peripheral artery occlusive disease (14).…”

Biomarkers for Diagnosis and Prediction of Outcomes in Contrast-Induced Nephropathy

“…In our study cohort, increased levels of β2M demonstrated prediction for early diagnosis of CIN and were associated with increased mortality. Several studies on β 2 M have focused on populations with underlying CKD [13]. In a study limited to a paediatric population, El-Frargy et al found significantly increased levels of baseline β 2 M in AKI patients compared to controls; however, the levels of serum creatinine remained unchanged [37,38].…”

“…Secondly, in the presence of renal disease including CIN, the impact of high β 2 M levels is heightened [40]. Other possible reasons include that β 2 M is a filtration biomarker produced by nucleated cells [13], which undergoes almost complete metabolism in the kidney. It is completely absorbed by megalinmediated endocytosis [13,27] and is also least affected by extra renal factors [27].…”

“…Previous studies have demonstrated that neutrophil gelatinase lipocalin-2 (NGAL), cystatin C, interleukin 18 (IL18), kidney injury molecule 1 (KIM1), and beta-2 microglobulin (β 2 M) are more sensitive early biomarkers of acute kidney injury (AKI) compared with serum creatinine [10,[12][13][14][15][16][17] and are better at predicting adverse clinical outcomes [18][19][20]. Biomarkers are needed for early identification of subclinical AKI, characterised by small increases in levels of serum creatinine [21], as previous studies have shown that even a small increase in serum creatinine (exceeding 44.3 μmol/l) was linked with a 7-fold increased risk of mortality [10,22].…”