{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T01:38:38Z","timestamp":1789609118995,"version":"build-2803163510"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2020,10,27]],"date-time":"2020-10-27T00:00:00Z","timestamp":1603756800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Dialysis Outcomes and Practice Patterns Study Programs"},{"name":"Baxter Healthcare"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,4,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Beta-2 microglobulin (\u03b22M) accumulates in hemodialysis (HD) patients, but its consequences are controversial, particularly in the current era of high-flux dialyzers. High-flux HD treatment improves \u03b22M removal, yet \u03b22M and other middle molecules may still contribute to adverse events. We investigated patient factors associated with serum \u03b22M, evaluated trends in \u03b22M levels and in hospitalizations due to dialysis-related amyloidosis (DRA), and estimated the effect of \u03b22M on mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We studied European and Japanese participants in the Dialysis Outcomes and Practice Patterns Study. Analysis of DRA-related hospitalizations spanned 1998\u20132018 (n\u2009=\u200923\u00a0976), and analysis of \u03b22M and mortality in centers routinely measuring \u03b22M spanned 2011\u201318 (n\u2009=\u20095332). We evaluated time trends with linear and Poisson regression and mortality with Cox regression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Median \u03b22M changed nonsignificantly from 2.71 to 2.65\u2009mg\/dL during 2011\u201318 (P\u2009=\u20090.87). Highest \u03b22M tertile patients (&amp;gt;2.9\u2009mg\/dL) had longer dialysis vintage, higher C-reactive protein and lower urine volume than lowest tertile patients (\u22642.3\u2009mg\/dL). DRA-related hospitalization rates [95% confidence interval (CI)] decreased from 1998 to 2018 from 3.10 (2.55\u20133.76) to 0.23 (0.13\u20130.42) per 100 patient-years. Compared with the lowest \u03b22M tertile, adjusted mortality hazard ratios (95% CI) were 1.16 (0.94\u20131.43) and 1.38 (1.13\u20131.69) for the middle and highest tertiles. Mortality risk increased monotonically with \u03b22M modeled continuously, with no indication of a threshold.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>DRA-related hospitalizations decreased over 10-fold from 1998 to 2018. Serum \u03b22M remains positively associated with mortality, even in the current high-flux HD era.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ckj\/sfaa155","type":"journal-article","created":{"date-parts":[[2020,7,14]],"date-time":"2020-07-14T19:09:56Z","timestamp":1594753796000},"page":"1436-1442","source":"Crossref","is-referenced-by-count":34,"title":["Beta-2 microglobulin and all-cause mortality in the era of high-flux hemodialysis: results from the\u00a0Dialysis Outcomes and Practice Patterns Study"],"prefix":"10.1093","volume":"14","author":[{"given":"Eiichiro","family":"Kanda","sequence":"first","affiliation":[{"name":"Medical Science, Kawasaki Medical School, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Muenz","sequence":"additional","affiliation":[{"name":"Arbor Research Collaborative for Health, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Bieber","sequence":"additional","affiliation":[{"name":"Arbor Research Collaborative for Health, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6962-8184","authenticated-orcid":false,"given":"Aleix","family":"Cases","sequence":"additional","affiliation":[{"name":"Medicine Department, Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Locatelli","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Ospedale Alessandro Manzoni, Azienda Socio Sanitaria Territoriale, Lecco, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Friedrich K","family":"Port","sequence":"additional","affiliation":[{"name":"Arbor Research Collaborative for Health, Ann Arbor, MI, USA"},{"name":"Professor Emeritus, University of Michigan, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Pecoits-Filho","sequence":"additional","affiliation":[{"name":"Arbor Research Collaborative for Health, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce M","family":"Robinson","sequence":"additional","affiliation":[{"name":"Arbor Research Collaborative for Health, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Perl","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Michael's Hospital, University of Toronto, Toronto, ON, 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