Abstract
Beta-2-microglobulin (B2M) is a low molecular weight polypeptide (11,800 Da) that exists in a free form and a form bound to cell membranes (light chains of HLA class I molecules). Their dosage is used in the exploration and monitoring of renal function in haemodialysis patients, hence the interest of this study, the objective of which is to study the different players involved in the increase of beta-2-microglobulin. Materials and Methods: This was a prospective and descriptive study from January 1st, 2017 to August 31, 2017 (08 months). All patients with chronic hemodialysis for 3 years or more were included. We analyzed sociodemographic, clinical and paraclinical data. Results: We collected 50 patients. The mean age was 50 ± 4.6 years with extremes of 30 and 82 years. The female sex predominated (52%). Chronic end-stage renal failure was hypertensive (86%), diabetic (4%). All patients benefited from intermittent hemodialysis for 8 hours per week using a low permeability membrane (cuprophane). The average duration of hemodialysis was 68 ± 6.4 months with extremes of 36 and 204 months. Twenty percent (20%) and four percent (4%) of chronic dialysis patients had joint pain and sensory deficit. Phalen’s sign was positive in 2% (1 case), Tinel’s sign in 2% (1 case) and carpal tunnel syndrome in 2% (1 case). The mean serum beta-2-microglobulin level was 58.34 ng/l with extremes of 16.99 and 112.24 ng/l. There was a correlation between hypertensive nephropathies and beta-2-microglobulin levels above 50 ng/l (P < 0.001). The mortality rate was 6%. Conclusion: Our study has objectified factors such as inadequate dialysis (8 hours/week), use of low permeability membrane in the increase of beta-2-microglobulin. The increase in serum beta-2-microglobulin levels in our patients is evidence of poor purification of medium molecules. Its reduction can be established by improving the quality of dialysis, in particular by using a high-permeability membrane.
Highlights
Beta-2-microglobulin (B-2-M) was discovered in 1968 by Berggard et al in the urine of patients with Wilson’s disease or chronic cadmium intoxication [1]
Their dosage is used in the exploration and monitoring of renal function in haemodialysis patients, the interest of this study, the objective of which is to study the different players involved in the increase of beta-2-microglobulin
Per dialytic monitoring of beta-2-microglobulin is currently considered a quality criterion for extra-renal treatment [3], the interest of its dosage in chronic hemodialysis to establish its prevalence in our context
Summary
Beta-2-microglobulin (B-2-M) was discovered in 1968 by Berggard et al in the urine of patients with Wilson’s disease or chronic cadmium intoxication [1]. It is a low molecular weight polypeptide that exists in free form and bound to cell membranes (light chain of class 1 histocompatibility molecules). Serum B-2-M is stable with usual values between 1.1 and 2.4 ng/l [2]. In case of renal failure, the serum level of beta-2-microglobulin increases. This elevation is the cause of several complications in chronic hemodialysis patients, including beta-2-microglobulin amyloidosis, which causes osteoarticular manifestations [3]. Per dialytic monitoring of beta-2-microglobulin is currently considered a quality criterion for extra-renal treatment [3], the interest of its dosage in chronic hemodialysis to establish its prevalence in our context
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