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Abstract: SA-PO417

β2-Microgloulin and α1-Microglobulin Reduction Ratios and Survival in Prevalent Dialysis Patients

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Mizuiri, Sonoo, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
  • Nishizawa, Yoshiko, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
  • Doi, Toshiki, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
  • Okubo, Aiko, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
  • Morii, Kenichi, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
  • Yamashita, Kazuomi, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
  • Shigemoto, Kenichiro, Iryo Hojin Ichiyokai Harada Byoin, Hiroshima, Japan
  • Masaki, Takao, Hiroshima Daigaku Byoin, Hiroshima, Hiroshima, Japan

Group or Team Name

  • Ichiyokai Harada Hospital
Background

The β2-microglobulin (β2-MG) and α1-microglobulin (α1-MG) molecular weights are 11,800 and 33,000 Da. There are several important middle molecules including fibroblast growth factor 23 around α1-MG. β2-MG and α1-MG reduction ratios (RRs) and dialysis patient survival were studied.

Methods

Subjects were prevalent dialysis patients (247 predilution online hemodiafiltration [Pre-OL-HDF] and 61 hemodialysis [HD] patients). Clinical data including β2-MG and α1-MG RRs were assessed at baseline. Kaplan-Meier curves, logistic regression analyses and Cox proportional hazard models were used to assess patient survival.

Results

Age, dialysis duration, and diabetes prevalence in all patients (n=308) were 67±12 years, 70 (42–140) months, and 47.4%, respectively. Over 450 days, 33 patients died. The mortality cut-off values for β2-MG RR and α1-MG RR using receiver operating characteristic curves were 78% and 20%, respectively. Patients with β2-MG RR ≥78% (n=131) showed significantly higher serum albumin (3.6±0.4 vs. 3.5±0.4 g/dL) and magnesium levels and Pre-OL-HDF frequency, but a significantly lower age and C-reactive protein levels than in patients with β2-MG RR <78% (n=177) (P <0.05). These differences were observed between patients with α1-MG RR ≥20% (n=134) and α1-MG RR <20% (n=174) (P <0.05). Kaplan–Meier survival rates were significantly higher in patients with β2-MG RR ≥78% than in patients with β2-MG RR <78% and in patients with α1-MG RR ≥20% than in patients with α1-MG RR <20% (P <0.05). In unadjusted Cox models, the β2-MG RR (hazard ratio [HR] 0.97, P<0.01) and α1-MG RR (HR 0.97, P <0.05) but not HDF were predictors of all-cause mortality. After adjusting for age, sex, diabetes, dialysis duration, C-reactive protein, and normalized protein catabolic rate, the β2-MG RR (HR 0.92, P <0.01) but not the α1-MG RR remained a significant predictor for mortality. α1-MG RRs were significantly correlated with β2-MG RRs (ρ=0.71, P <0.0001) and serum albumin levels (ρ=0.21, P <0.001). β2-MG RRs were significantly correlated with serum albumin levels (ρ=0.23, P <0.0001).

Conclusion

In patients on Pre-OL-HDF or HD, higher β2-MG and α1-MG RRs showed better survival, and the β2-MG RRs was a significant determinant for mortality. Higher β2-MG and α1-MG RRs were not related to lower serum albumin levels.

Funding

  • Private Foundation Support