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Titolo	Serum β2-microglobulin level is a significant predictor of mortality in maintenance haemodialysis patients
Autore	Senji Okuno1, Eiji Ishimura2, Kaori Kohno1, Yoko Fujino-Katoh1, Yoshifumi Maeno1, Tomoyuki Yamakawa1, Masaaki Inaba2 and Yoshiki Nishizawa2 1Kidney Center, Shirasagi Hospital and 2Osaka City University Graduate School of Medicine, Osaka, JapanSenji Okuno1, Eiji Ishimura2, Kaori Kohno1, Yoko Fujino-Katoh1, Yoshifumi Maeno1, Tomoyuki Yamakawa1, Masaaki Inaba2 and Yoshiki Nishizawa2 1Kidney Center, Shirasagi Hospital and 2Osaka City University Graduate School of Medicine, Osaka, Japan
Referenza	Nephrol Dial Transplant 2009; 24: 571-577
Contenuto	Background. β2-Microglobulin (β2-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 β2-M levels with clinical outcome in dialyzed patients. Methods. The prognostic implication of serum β2-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 β2-M levels: lower β2-M group (n = 245) with serum β2-M <32.2 mg/L (the median serumβ2-M) and higher β2-M group (n=245) with that ≥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 β2-M group was significantly higher compared to that in the lower β2-M group (P < 0.001). Multivariate Cox proportional hazards analyses showed that serum β2-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 β2-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 β2-M in these patients.
Data	24.02.2009

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