Serum [beta][sub.2]-Microglobulin Predicts Mortality in Peritoneal Dialysis Patients: A Prospective Cohort Study

Background/Aims: [beta][sub.2]-Microglobulin ([beta][sub.2]-M) is a surrogate marker of middle-molecule uremic toxins and is associated with mortality in chronic hemodialysis patients. However, the impact of serum [beta][sub.2]-M levels on mortality in peritoneal dialysis (PD) patients is uncertain....

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Published inAmerican journal of nephrology Vol. 42; no. 2; p. 91
Main Authors Kim, Nam Ho, Kim, Young Ok, Kim, Yon Su, Koh, Eun Sil, Yang, Chul Woo, Kim, Su Hyun, Kim, Yong Kyun, Choi, Euy Jin, Kim, Yong Lim, Kang, Shin Wook, Jin, Dong Chan, Lee, Kyungsoo, Song, Ho Chul
Format Journal Article
LanguageEnglish
Published S. Karger AG 01.10.2015
Subjects
Beta globulins
Care and treatment
Chronic kidney failure
Health aspects
Patient outcomes
Peritoneal dialysis
South Korea
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Summary:Background/Aims: [beta][sub.2]-Microglobulin ([beta][sub.2]-M) is a surrogate marker of middle-molecule uremic toxins and is associated with mortality in chronic hemodialysis patients. However, the impact of serum [beta][sub.2]-M levels on mortality in peritoneal dialysis (PD) patients is uncertain. The purpose of this study was to examine the association of serum [beta][sub.2]-M levels with all-cause mortality in PD patients. Methods: A total of 771 PD patients were selected from the Clinical Research Center registry for end-stage renal disease cohort in Korea. Patients were categorized into 3 groups by tertiles of serum [beta][sub.2]-M levels. The primary outcome was all-cause mortality. Results: The median value of serum [beta][sub.2]-M was 23.6 mg/l (interquartile range 14.8-33.4 mg/l), and the median follow-up period was 39 months. The Kaplan-Meier analysis showed that the all-cause mortality rate was significantly different according to tertiles of serum [beta][sub.2]-M in PD patients (p = 0.03, log-rank). Multivariate Cox proportional analysis showed that the hazards ratio for all-cause mortality was 1.02 (95% CI 1.01-1.04, p = 0.006) per 1 mg/l increase in [beta][sub.2]-M after adjustment for multiple confounding factors that relate to malnutrition and inflammation marker. However, serum [beta][sub.2]-M was not associated with all-cause mortality after adjustment for residual renal clearance. Conclusions: These results are supportive of the potential role of the serum [beta][sub.2]-M level as a predictor of mortality in PD patients. Keywords: β.sub.2-Microglobulin, Mortality, Peritoneal dialysis
ISSN:0250-8095