학술논문

α1‐ and β2‐Microglobulin reduction ratios and survival in patients on predilution online haemodiafiltration.
Document Type
Article
Source
Nephrology. Jan2023, Vol. 28 Issue 1, p44-50. 7p.
Subject
*OVERALL survival
*SERUM albumin
*SURVIVAL rate
*MORTALITY
MORTALITY risk factors
Language
ISSN
1320-5358
Abstract
Aim: β2‐Microglobulin (β2‐MG) and α1‐microglobulin (α1‐MG) have molecular weights of 11,800 and 33,000 Da, respectively. We studied the α1‐MG and β2‐MG reduction ratios (RRs) and survival in patients on predilution online haemodiafiltration (Pre‐OL‐HDF). Methods: Participants were 247 Pre‐OL‐HDF patients. α1‐MG and β2‐MG RRs were assessed at baseline. Kaplan–Meier survival and Cox proportional hazard analyses were used. Results: In 247 patients, the median age was 67 (56–73) years, the dialysis duration was 77 (46–150) months, and the diabetes prevalence was 47.4%. Twenty‐two patients died over the 450‐day study period. The mortality cut‐off values using receiver‐operating characteristic curves for the α1‐MG and β2‐MG RRs were 20% and 80%, respectively. Survival rates were significantly (p < 0.05) higher in patients with α1‐MG RRs ≥20% (n = 134) compared with patients with α1‐MG RRs <20% (n = 113) and in patients with β2‐MG RRs ≥80% (n = 87) compared with patients with β2‐MG RRs <80% (n = 160). Cox models adjusting for diabetes and dialysis duration showed that α1‐MG RR, β2‐MG RR, and pre‐ and postdialysis β2‐MG were risk factors for all‐cause mortality; however, after additional adjustment for age, sex, and serum albumin, only β2‐MG RR and pre‐ and postdialysis β2‐MG were significant predictors of mortality (p < 0.05). α1‐MG RRs were significantly correlated with β2‐MG RRs (ρ = 0.73, p < 0.0001) and serum albumin levels (ρ = 0.13, p < 0.05). Conclusion: In patients on Pre‐OL‐HDF, α1‐MG RRs ≥20% and β2‐MG RRs ≥80% were associated with better survival, β2‐MG RR ≥80% and pre‐and postdialysis β2‐MG levels were significant predictors of all‐cause mortality, and α1‐MG RR ≥20% may predict mortality. Summary at a Glance: α1‐microglobulin (α1‐MG) and β2‐microglobulin (β2‐MG) reduction ratios (RRs) and survival in 247 patients on predilution online haemodiafiltration (Pre‐OL‐HDF) were assessed. α1‐MG RRs ≥20% and β2‐MG RRs ≥80% were associated with better survival, β2‐MG and β2‐MG RR were predictors of mortality, and α1‐MG RR may predict mortality. [ABSTRACT FROM AUTHOR]