Document Detail


Serum beta2-microglobulin level is a significant predictor of mortality in maintenance haemodialysis patients.
MedLine Citation:
PMID:  18799606     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Beta(2)-microglobulin (beta(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 beta(2)-M levels with clinical outcome in dialyzed patients. METHODS: The prognostic implication of serum beta(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 beta(2)-M levels: lower beta(2)-M group (n = 245) with serum beta(2)-M <32.2 mg/L (the median serum beta(2)-M) and higher beta(2)-M group (n = 245) with that >or=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 beta(2)-M group was significantly higher compared to that in the lower beta(2)-M group (P < 0.001). Multivariate Cox proportional hazards analyses showed that serum beta(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 beta(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 beta(2)-M in these patients.
Authors:
Senji Okuno; Eiji Ishimura; Kaori Kohno; Yoko Fujino-Katoh; Yoshifumi Maeno; Tomoyuki Yamakawa; Masaaki Inaba; Yoshiki Nishizawa
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Publication Detail:
Type:  Journal Article     Date:  2008-09-17
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  24     ISSN:  1460-2385     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-01-15     Completed Date:  2009-03-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  571-7     Citation Subset:  IM    
Affiliation:
Kidney Center, Shirasagi Hospital, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Biological Markers / blood
Cardiovascular Diseases / etiology,  mortality
Female
Humans
Japan / epidemiology
Kaplan-Meiers Estimate
Kidney Failure, Chronic / blood,  complications,  mortality,  therapy
Male
Middle Aged
Multivariate Analysis
Prognosis
Proportional Hazards Models
Renal Dialysis / adverse effects,  mortality*
Toxins, Biological / blood
beta 2-Microglobulin / blood*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Toxins, Biological; 0/beta 2-Microglobulin; 0/uremia middle molecule toxins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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