Pediatric nephrology (Berlin, Germany) · 2025
Correlation of serum beta-2 microglobulin with hemodialysis prescription and comorbid factors in children undergoing chronic hemodialysis.
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Sari Budyarini Prima, Pardede Sudung O, Wahidiyat Pustika Amalia, Pulungan Aman, Hidayati Eka Laksmi, Yanuarso Piprim Basarah
Аннотация
BACKGROUND: Hemodialysis (HD) is a method of kidney replacement therapy designed to remove uremic toxins from the body. Beta-2 microglobulin (beta-2 MG) is a middle molecule not yet effectively removed by conventional low-flux dialysis membranes and may contribute to long-term complications in chronic HD patients. While well-studied in adults, data in pediatric populations are limited. This study evaluated beta-2 MG levels before and after HD in children and assessed associations with dialysis prescription parameters and cardiovascular comorbidities.
METHODS: A cross-sectional study was conducted from June to July 2024 at the Kiara Children's Dialysis Unit, Rumah Sakit Umum Pusat Nasional (RSUPN) Cipto Mangunkusumo, Indonesia. Pre- and post-HD beta-2 MG levels were measured. Dialysis prescriptions, laboratory values, and cardiovascular parameters were recorded and analyzed for correlations with beta-2 MG levels and reduction ratios.
RESULTS: The study involved 38 subjects, of whom 22 (57.9%) were male, with an average age of 13.2 ± 2.9 years. Most patients received HD twice weekly. Pre-HD beta-2 MG levels were elevated in all patients. Synthetic-based high-flux dialyzers were significantly associated with greater beta-2 MG reduction ratios compared to cellulose-based low-flux membranes (r = 0.716; p = 0.000). No significant correlations were found between beta-2 MG levels and other HD parameters, laboratory markers, or cardiovascular outcomes.
CONCLUSIONS: Synthetic-based high-flux dialyzers were associated with improved beta-2 MG clearance in pediatric HD patients, though pre-HD levels were comparable across membrane types. Further longitudinal studies are warranted to determine the clinical significance of beta-2 MG reduction and guide dialysis optimization in children.
METHODS: A cross-sectional study was conducted from June to July 2024 at the Kiara Children's Dialysis Unit, Rumah Sakit Umum Pusat Nasional (RSUPN) Cipto Mangunkusumo, Indonesia. Pre- and post-HD beta-2 MG levels were measured. Dialysis prescriptions, laboratory values, and cardiovascular parameters were recorded and analyzed for correlations with beta-2 MG levels and reduction ratios.
RESULTS: The study involved 38 subjects, of whom 22 (57.9%) were male, with an average age of 13.2 ± 2.9 years. Most patients received HD twice weekly. Pre-HD beta-2 MG levels were elevated in all patients. Synthetic-based high-flux dialyzers were significantly associated with greater beta-2 MG reduction ratios compared to cellulose-based low-flux membranes (r = 0.716; p = 0.000). No significant correlations were found between beta-2 MG levels and other HD parameters, laboratory markers, or cardiovascular outcomes.
CONCLUSIONS: Synthetic-based high-flux dialyzers were associated with improved beta-2 MG clearance in pediatric HD patients, though pre-HD levels were comparable across membrane types. Further longitudinal studies are warranted to determine the clinical significance of beta-2 MG reduction and guide dialysis optimization in children.