Plasma beta-2 microglobulin is associated with cardiovascular disease in uremic patients

Liabeuf, Sophie; Lenglet, Aurélie; Desjardins, Lucie; Neirynck, Nathalie; Glorieux, Griet; Lemke, Horst‐Dieter; Vanholder, Raymond; Choukroun, Gabriel; Massy, Ziad A.

doi:10.1038/ki.2012.301

Cited by 145 publications

(122 citation statements)

References 35 publications

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“…Although marked elevation of serum β 2 MG is a prerequisite for the formation of β 2 MG fibrils [1,31,32], the K/DOQI clinical guideline suggests that, on the other hand, the level of serum β 2 MG may not be directly associated with onset of DRA symptoms [33]. Our adjusted analysis suggests that in the patients we studied, high pretreatment β 2 MG level was not associated with DRA, though the crude risk of DRA was higher in these patients.…”

Section: Discussionmentioning

confidence: 99%

Carpal Tunnel Surgery as Proxy for Dialysis-Related Amyloidosis: Results from the Japanese Society for Dialysis Therapy

et al. 2014

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Background/Aims: This study aims to identify current risk factors for developing dialysis-related amyloidosis using carpal tunnel syndrome (CTS) as proxy for general amyloidosis. Methods: The cohort consisted of 166,237 patients on dialysis (mean age 66.1 ± 12.4 years; mean dialysis vintage 7.2 ± 6.4 years) who could be followed for a year between 2010 and 2011. Of these, 2,157 (1.30%) needed first-time CTS surgery during the study period. Odds ratios (ORs) for CTS were calculated at a 95% confidence interval (95% CI) after adjusting for age, gender, primary kidney disease, history of smoking, history of hypertension vintage, dialysis modality, use of high-flux membrane, body mass index, serum albumin, Kt/V, normalized protein catabolic rate, C-reactive protein, pretreatment β₂-microglobulin (β₂MG), and β₂MG clearance. Results: Adjusted ORs of first-time CTS for vintages 10-15, 15-20, 20-25 (referent), 25-30, and >30 years were, respectively, 0.18 (0.12-0.26), 0.43 (0.31-0.62), 1.00, 2.37 (1.64-3.40), and 3.87 (2.52-5.93). Adjusted ORs for ages 40-50, 50-60 (referent), 60-70, 70-80, and >80 were 0.53 (0.30-0.94), 1.00, 1.89 (1.41-2.52), 1.52 (1.08-2.14), and 1.04 (0.60-1.80). Female gender, low serum albumin, and diabetic nephropathy were also associated with CTS. Pretreatment serum β₂MG and β₂MG clearance <80% were not significant, although β₂MG clearance >80% was negatively associated with CTS [OR 0.34 (0.13-0.90)]. Conclusion: ORs of first-time CTS almost doubled with every 5-year increase in dialysis vintage. ORs of CTS were highest for patients aged 60-70. Other factors associated with CTS were gender, serum albumin, and diabetic nephropathy. β₂MG clearance >80% may decrease the incidence of CTS.

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Section: Discussionmentioning

confidence: 99%

Carpal Tunnel Surgery as Proxy for Dialysis-Related Amyloidosis: Results from the Japanese Society for Dialysis Therapy

et al. 2014

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“…An elevated serum level of B2M has been found to be associated with CVD (3,4) and increased mortality (3,4,5,6) in patients with renal dysfunction, in the elderly population as well as in the general population. Interestingly, although B2M is known to be a marker of renal function, the effect of B2M on allcause mortality was found to be independent of renal function in the prospective study with 1034 nondisabled persons aged 65 years or older (6).…”

Section: Introductionmentioning

confidence: 99%

Serum β-2 microglobulin predicts mortality in people with diabetes

Cheung

Lam

Cheung

2013

European Journal of Endocrinology

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Objective: Serum b-2 microglobulin (B2M) level predicts mortality in chronic kidney disease. Glycation of B2M is cytotoxic and may contribute to the risk of mortality in diabetic patients. Our objective was to evaluate the relationship between B2M and mortality in diabetic patients. Methods: In this prospective study, 896 participants of the Third National Health and Nutrition Examination Survey with diabetes were included in the analysis. Serum B2M level was used in multivariate Cox regression analysis to predict all-cause and diabetes-related mortality. Results: During a median follow-up of 11.8 years (range 0.1-18.2 years) and 9220.5 person/years, 541 (42.4%) and 207 (16.8%) participants died from all causes and diabetes-related causes respectively. One natural-log unit of B2M was significantly associated with all-cause (hazard ratio (HR)Z6.53, 95% CI 2.07-20.6) and diabetes mortality (HRZ7.35, 95% CI 1.01-53.38) after multivariable adjustment. Similar results were obtained when B2M was analyzed as tertiles or in the threshold model (T1CT2 vs T3). Examination of regression splines suggests a linear increase in hazard for mortality with increasing B2M levels. Conclusions: Serum B2M level is a novel predictor of all-cause and diabetes-related mortality in people with diabetes regardless of renal function.

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“…More recently, there is a growing interest on the effects of β2M on the cardiovascular system. Higher levels of β2M have been associated with arterial stiffness, vascular calcification, and higher mortality [37] . In the HEMO study, high serum levels of β2M was associated with an increased risk of mortality, mainly due to infectious disease [38] .…”

Section: Beta2-microglobulinmentioning

confidence: 99%

Uremia Retention Molecules and Clinical Outcomes

Barreto¹,

Barreto²,

Canziani³

2017

Expanded Hemodialysis: Innovative Clinical Approach in Dialysis

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Chronic kidney disease is characterized by the accumulation of organic compounds in the bloodstream that may exert a variety of toxic effects in the body. These compounds, collectively known as uremic toxins, may be classified according to their physicochemical properties as free water-soluble low molecular weight molecules, middle molecules or protein-bound uremic toxins. Most of these retention molecules, due to either their size and/or binding to protein, constitute a complex therapeutic challenge to the nephrologist, particularly in end-stage renal disease, because of their limited removal by conventional dialysis therapies. Therefore, we review in this article the current clinical evidences that have supported the important role of uremic toxins in uremia by contributing to the adverse outcomes related to chronic kidney disease, such as increased mortality and cardiovascular events, as well as renal impairment progression that cannot be solely explained by traditional risk factors. These observations have ultimately contributed to testing new therapeutic targets, such as the gut, and the development of modern dialysis strategies to manage chronic kidney disease patients.

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Plasma beta-2 microglobulin is associated with cardiovascular disease in uremic patients

Cited by 145 publications

References 35 publications

Carpal Tunnel Surgery as Proxy for Dialysis-Related Amyloidosis: Results from the Japanese Society for Dialysis Therapy

Carpal Tunnel Surgery as Proxy for Dialysis-Related Amyloidosis: Results from the Japanese Society for Dialysis Therapy

Serum β-2 microglobulin predicts mortality in people with diabetes

Uremia Retention Molecules and Clinical Outcomes

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