Utility of serum β2-microglobulin for prediction of kidney outcome among patients with biopsy-proven diabetic nephropathy

被引:1
作者
Uemura, Takayuki [1 ]
Nishimoto, Masatoshi [1 ]
Eriguchi, Masahiro [1 ,5 ]
Tamaki, Hiroyuki [1 ]
Tasaki, Hikari [1 ]
Furuyama, Riri [1 ]
Fukata, Fumihiro [2 ]
Kosugi, Takaaki [1 ]
Morimoto, Katsuhiko [3 ]
Matsui, Masaru [1 ,4 ]
Samejima, Ken-ichi [1 ]
Tsuruya, Kazuhiko [1 ]
机构
[1] Nara Med Univ, Dept Nephrol, Nara, Japan
[2] Yamatotakada Municipal Hosp, Dept Nephrol, Nara, Japan
[3] Nara Prefecture Seiwa Med Ctr, Dept Nephrol, Nara, Japan
[4] Nara Prefecture Gen Med Ctr, Dept Nephrol, Nara, Japan
[5] Nara Med Univ, Dept Nephrol, 840 Shijo cho, Kashihara, Nara 6348521, Japan
关键词
cohort study; diabetic nephropathy; observational study; real-world evidence; TUMOR-NECROSIS-FACTOR; NEONATAL FC-RECEPTOR; CARDIOVASCULAR-DISEASE; BETA(2)-MICROGLOBULIN LEVEL; MORTALITY; PROTEIN; ESRD; ACTIVATION; CREATININE; BIOMARKERS;
D O I
10.1111/dom.15347
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aim: To examine whether serum beta 2-microglobulin (beta 2-MG) could improve the prediction performance for kidney failure with replacement therapy (KFRT) among patients with diabetic nephropathy (DN).Methods: Patients with biopsy-proven DN at Nara Medical University Hospital were included. The exposure of interest was log-transformed serum beta 2-MG levels measured at kidney biopsy. The outcome variable was KFRT. Multivariable Cox regression models and competing-risk regression models, with all-cause mortality as a competing event, were performed. Model fit by adding serum beta 2-MG levels was calculated using the Akaike information criterion (AIC). The net reclassification improvement (NRI) and integrated discrimination improvement (IDI) indexes were used to evaluate the improvement of predictive performance for 5-year cumulative incidence of KFRT by serum beta 2-MG levels.Results: Among 408 patients, 99 developed KFRT during a median follow-up period of 6.7 years. A higher serum beta 2-MG level (1-unit increase in log-transformed serum beta 2-MG level) was associated with a higher incidence of KFRT, even after adjustments for previously known clinical and histological risk factors (hazard ratio [95% confidence interval {CI}]: 3.30 [1.57-6.94] and subdistribution hazard ratio [95% CI]: 3.07 [1.55-6.06]). The addition of log-transformed serum beta 2-MG level reduced AIC and improved the prediction of KFRT (NRI and IDI: 0.32 [0.09-0.54] and 0.03 [0.01-0.56], respectively).Conclusions: Among patients with biopsy-proven DN, serum beta 2-MG was an independent predictor of KFRT and improved prediction performance. In addition to serum creatinine, serum beta 2-MG should probably be measured for DN.
引用
收藏
页码:583 / 591
页数:9
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