The following is a summary of “α1- and β2-Microglobulin reduction ratios and survival in patients on predilution online haemodiafiltration,” published in the January 2023 issue of Nephrology by Mizuiri, et al.

The molecular weights of β2-Microglobulin (β2-MG) and α1-Microglobulin (α1-MG) are 11,800 and 33,000 Da, respectively. For a study, researchers looked at the survival rates in patients receiving predilution online hemofiltration (Pre-OL-HDF) and the α1-MG and β2-MG reduction ratios (RRs).

There were 247 Pre-OL-HDF patients that participated. The baseline assessment of 1-MG and 2-MG RRs. The analyses employed were Cox proportional hazard and Kaplan-Meier survival.

Dialysis lasted 77 (46-150) months for 247 patients with a median age of 67 (56-73) years and a prevalence of diabetes of 47.4%. Throughout the 450-day research period, 22 patients passed away. The receiver-operating characteristic curves’ mortality cut-off values for the α1-MG and β2-MG RRs were 20% and 80%, respectively. In patients with α1-MG RRs≥ 20% (n = 134) compared to patients with α1-MG RRs< 20% (n = 113) and in patients with β2-MG RRs ≥80% (n = 87) compared to patients with β2-MG RRs <80% (n = 160), survival rates were considerably (P< 0.05) higher in both groups of patients. However, after further adjusting for age, sex, and serum albumin, only β2-MG RR and pre-, and post-dialysis 2-MG were significant predictors of mortality (P< 0.05). This is because Cox models adjusting for diabetes and dialysis duration revealed that α1-MG RR, β2-MG RR, and pre-and post-dialysis 2-MG were risk factors for all-cause mortality. When compared to β2-MG RRs (ρ = 0.73, P< 0.0001) and serum albumin levels (ρ = 0.13, P < 0.05), 1-MG RRs were substantially linked with both and the latter.

In Pre-OL-HDF patients, α1-MG RRs≥ 20% and β2-MG RRs≥ 80% were linked to better survival, β2-MG RR ≥80%, and pre- and post-dialysis β2-MG levels were significant predictors of all-cause death, and α1-MG RR ≥20% may be a marker for mortality.

Reference: onlinelibrary.wiley.com/doi/10.1111/nep.14125