Evaluation of the Therapeutic Effects of Beta2-Microglobulin Adsorption on Dialysis-Related Amyloidosis Using a Clinical Claims Database.

INTRODUCTION

Dialysis-related amyloidosis (DRA) is a refractory complication of long-term dialysis caused by β2-microglobulin (β2MG) deposition. While β2MG adsorption columns remove β2MG, their impact on preventing re-surgery remains unclear.

METHODS

This a noninterventional, population-based cohort study used a large-scale medical claims database. This study included patients with chronic kidney disease undergoing maintenance hemodialysis (HD) and diagnosed with DRA. The exposure group received β2MG adsorption column therapy, while the control group was divided into online hemodiafiltration (OHDF) and HD subgroups. The primary endpoint was carpal tunnel or trigger finger release.

RESULTS

Among 3,946 eligible patients, 212 patients in the β2MG adsorption column group, 139 in the OHDF group, and 237 in the HD group were included; the primary endpoint occurred in 28 (13.2%), 21 (15.1%), and 37 (15.6%) patients, respectively. Although there was a trend toward a lower incidence in the β2MG adsorption column group, no significant difference was observed (p = 0.43). The adjusted hazard ratio for the β2MG adsorption column group (HD group as reference) tended to be low (0.68, 95% CI: 0.41-1.13), but this difference was not significant.

CONCLUSIONS

Although there was no statistically significant difference, the findings suggest that the β2MG adsorption column may help slow DRA progression.