Serum β2-Microglobulin Predicts Mortality in Peritoneal Dialysis Patients: A Prospective Cohort Study

Am J Nephrol. 2015;42(2):91-8. doi: 10.1159/000439060. Epub 2015 Sep 5.

Abstract

Background/aims: β2-Microglobulin (β2-M) is a surrogate marker of middle-molecule uremic toxins and is associated with mortality in chronic hemodialysis patients. However, the impact of serum β2-M levels on mortality in peritoneal dialysis (PD) patients is uncertain. The purpose of this study was to examine the association of serum β2-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 β2-M levels. The primary outcome was all-cause mortality.

Results: The median value of serum β2-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 β2-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 β2-M after adjustment for multiple confounding factors that relate to malnutrition and inflammation marker. However, serum β2-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 β2-M level as a predictor of mortality in PD patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Kidney Failure, Chronic / blood
  • Kidney Failure, Chronic / therapy*
  • Linear Models
  • Male
  • Middle Aged
  • Mortality*
  • Multivariate Analysis
  • Peritoneal Dialysis*
  • Prognosis
  • Proportional Hazards Models
  • Prospective Studies
  • Registries*
  • Republic of Korea
  • beta 2-Microglobulin / blood*

Substances

  • beta 2-Microglobulin