Kidney Week

Abstract: FR-PO1024

Symptoms Associated with Dialysis-Related Amyloidosis and Beta-2 Microglobulin Blood Levels in Patients on Maintenance Hemodialysis in a Dialysis Center in California

Session Information

• Hemodialysis: Clinical Challenges, Patient-Centered Outcomes, and Quality of Life
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Dialysis

• 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

• Bommireddi, Akshay, Harbor-UCLA Medical Center, Torrance, California, United States

Akshay Bommireddi, MD

• Shah, Anuja P., Harbor-UCLA Medical Center, Torrance, California, United States

Anuja P. Shah, MD

• Elali, Ibrahim, Harbor-UCLA Medical Center, Torrance, California, United States

Ibrahim Elali, MD

• Dai, Tiane, Harbor-UCLA Medical Center, Torrance, California, United States

Tiane Dai, MD, PhD

• Dukkipati, Ramanath B., Harbor-UCLA Medical Center, Torrance, California, United States

Ramanath B. Dukkipati, MD

• Shen, Jenny I., Harbor-UCLA Medical Center, Torrance, California, United States

Jenny I. Shen, MD, MS, FASN

• Kalantar-Zadeh, Kamyar, Harbor-UCLA Medical Center, Torrance, California, United States

Kamyar Kalantar-Zadeh, MD, DrMed, PhD, MPH, FASN

• Kopple, Joel D., Harbor-UCLA Medical Center, Torrance, California, United States

Joel D. Kopple, MD, FASN

Group or Team Name

• Harbor UCLA Nephrology

Background

Dialysis-related amyloidosis (DRA), caused by beta-2 microglobulin (B2M) accumulation, remains an important complication of long-term hemodialysis. We evaluated associations among dialysis vintage, serum B2M levels, RRF, and DRA-associated musculoskeletal symptoms within a continuous quality assurance program at a U.S. academic-affiliated dialysis center.

Methods

We performed a cross-sectional study of 156 adults receiving MHD. Serum B2M and clinical variables were obtained from the electronic medical record. DRA-associated symptoms, including shoulder pain and carpal tunnel syndrome, were assessed using a standardized questionnaire. Multivariable linear regression adjusted for dialysis vintage, age, sex, body weight, and RRF status. Additional analyses included LOESS regression, and correlation analyses.

Results

Mean dialysis vintage was 6.9 ± 6.8 years and mean serum B2M was 21.8 ± 7.0 mg/L. DRA-associated symptoms were present in 28.1% of patients. Longer dialysis vintage correlated with higher B2M levels (Pearson r=0.19, P=0.02; Spearman ρ=0.32, P<0.001). Patients with preserved RRF demonstrated lower B2M levels (19.4 ± 6.3 vs 24.1 ± 6.9 mg/L; P<0.001) and lower prevalence of DRA-associated symptoms (17.5% vs 36.8%; P=0.02). In multivariable analysis, absence of RRF was the strongest independent predictor of elevated B2M levels (β=5.16; 95% CI, 1.93–8.38; P=0.002). Serum B2M levels alone were not associated with symptom burden.

Conclusion

Preserved RRF was strongly associated with lower B2M accumulation and fewer DRA-associated symptoms in MHD patients. These findings support strategies aimed at preserving kidney function in long-term hemodialysis patients and highlight the need for improved characterization of DRA manifestations beyond serum B2M levels alone.