Serum  2-microglobulin level is a significant predictor of mortality in maintenance haemodialysis patients

Abstract

Background. β 2 -Microglobulin (β 2 -M) is recognized as a surrogate marker of middle-molecule uraemic toxins and is a key component in the genesis of dialysis-associated amyloidosis. Few studies have evaluated the association of β 2 -M levels with clinical outcome in dialyzed patients. Methods. The prognostic implication of serum β 2 -M levels for the survival of haemodialysis patients was examined in 490 prevalent haemodialysis patients (60.1 ± 11.8 years, haemodialysis duration of 87.4 ± 75.7 months, 288 males and 202 females; 24% diabetics). The patients were divided into two groups according to their serum β 2 -M levels: lower β 2 -M group (n = 245) with serum β 2 -M <32.2 mg/L (the median serum β 2 -M) and higher β 2 -M group (n = 245) with that ≥32.2 mg/L. Results. During the follow-up period of 40 ± 15 months, there were 91 all-cause deaths, and out of them, 36 were from cardiovascular diseases. Kaplan-Meier analysis revealed that all-cause mortality in the higher β 2 -M group was significantly higher compared to that in the lower β 2 -M group (P < 0.001). Multivariate Cox proportional hazards analyses showed that serum β 2 -M level was a significant predictor for all-cause mortality (hazard ratio, 1.05; 95% CI, 1.01-1.08; P = 0.005), and for non-cardiovascular mortality (hazard ratio, 1.06; 95% CI, 1.02-1.10; P = 0.006), after adjustment for age, gender, haemodialysis duration, the presence of diabetes, serum albumin and serum C-reactive protein.Conclusion. These results demonstrate that the serum β 2 -M level is a significant predictor of mortality in haemodialysis patients, independent of haemodialysis duration, diabetes, malnutrition and chronic inflammation, suggesting the clinical importance of lowering serum β 2 -M in these patients.

Differences in associated factors between aortic and mitral valve calcification in hemodialysis

“…18 In patients on HD, serum b 2 M is markedly increased and predicts all-cause mortality, 19,20 but studies on the relationship between serum b 2 M and cardiovascular disease are limited. It has been reported that serum b 2 M correlates with carotid IMT 21 and the number of calcified valves.…”

Clinical outcomes for maintenance hemodialysis patients using a high-flux (FX60) dialyzer

“…Based on the Hemodialysis (HEMO) study, we used 20 mL/h/mmHg as the cutoff point to differentiate low and high flux. 3 Our patients began the study by receiving dialysis on a NIPRO 130G (low-flux, Osaka, Japan) dialyzers for at least two years and were then changed to FX60 (highflux, Fresenius, Bad Homburg, Germany) dialyzers for three years. The performance and technical data of the NIPRO 130G (Nipro, Osaka, Japan) and FX60 (Fresenius, Bad Homburg, Germany) are summarized in Table 1.…”

Role of Residual Kidney Function and Convective Volume on Change in β2-Microglobulin Levels in Hemodiafiltration Patients

“…In hemodialysis (HD) patients, serum ␤2M levels may be increased by 20-fold or more as compared with the general population, the highest levels being observed in patients without residual kidney function (RKF) (4)(5)(6). It has been shown that predialysis ␤2M levels predict all-cause and infectious-related mortality in these patients (4,7,8).…”