Impact of Serum β2-microglobulin Levels on Hospitalization for Cardiovascular Diseases or Infection in Chronic Hemodialysis Patients

Background β2-microglobulin is a surrogate marker of middle-molecule uremic toxins and serum β2-microglobulin levels are associated with all-cause mortality in hemodialysis (HD) patients.In this study, we investigated the impact of serum β2-microglobulin levels on cardiovascular and infectious diseases in chronic HD patients. Methods Prevalent HD patients were selected from the Clinical Research Center registry for End Stage Renal Disease, a multicenter prospective cohort study on dialysis patients in Korea. Patients were categorized into three groups by tertiles of serum β2-microglobulin levels as follows: Tertile 1, β2-microglobulin 32.24 mg/L. Cox regression analysis was used to calculate the adjusted hazard ratio (HR) for first cardiovascular diseases or infection related-hospitalizations. Results A total of 1,012 prevalent HD patients were included in this study. The median follow-up period was 24 months. Multivariate Cox proportional hazard model showed that highest tertile had significantly increased risk of cardiovascular diseases related-hospitalizations compared with the lowest tertile (HR: 1.68, 95% CI: 1.05-2.67). The risk of infection related-hospitalizations was significantly increased in higher tertiles compared with lowest tertile (Tertile 2; HR 1.66, 95% CI: 1.07-2.58, Tertile 3; 1.88, 95% CI, 1.23-2.88) after adjustment for clinical variables. Conclusions Our data showed that the serum β2-microglobulin levels were significant predictor of clinical outcome for cardiovascular disease or infection in chronic HD patients.