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Kidney Week

Abstract: FR-PO1158

Association between Serum β2-Microglobulin and Executive Function in Patients with Nondialysis-Dependent CKD: The VCOHP Study

Session Information

Category: CKD (Non-Dialysis)

  • 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Tsuruya, Kazuhiko, Nara Kenritsu Ika Daigaku, Kashihara, Nara, Japan
  • Yoshida, Hisako, Osaka Koritsu Daigaku, Osaka, Osaka, Japan
Background

Previously, we investigated the association between grey matter (GM) volume ratio (GMR) on brain MRI and the executive function assessed by trail making test (TMT) in 95 patients with non-dialysis chronic kidney disease (ND-CKD). We reported a significant negative correlation between GMR and TMT scores (Tsuruya K, et al. PLoS One 2015;10(12):e0143706). β2-microglobulin (BMG) is a low molecular weight protein composed of 99 amino acids, with a molecular weight of 11,800 and no sugar chains. As the glomerular filtration rate (GFR) decreases, serum BMG levels rise because it is no longer excreted into the urine, thus elevating in cases of kidney dysfunction. Cognitive impairment (CI) and brain atrophy have been reported to progress with declining of GFR. Since BMG levels increase as GFR declines, a possible association between BMG levels and CI has been considered; however, it has not been fully elucidated to date. Therefore, we examined this association in patients with ND-CKD.

Methods

We conducted a cross-sectional study with 95 ND-CKD patients who had no overt CI or history of stroke. The subjects underwent brain MRI scans and completed TMT part A (TMT-A) and part B (TMT-B). The segmentation algorithm from Statistical Parametric Mapping 8 software was applied to each T1-weighted MRI scan to extract tissue maps corresponding to GM, white matter (WM), and cerebrospinal fluid (CSF). To normalize for head size variability, GMR was calculated as the ratio of GM volume to the total intracranial volume, which is the sum of GM, WM, and CSF volumes.

Results

A linear regression analysis demonstrated significant associations between serum BMG levels and the scores of TMT-A, TMT-B, and ΔTMT (TMT-B – TMT-A) in the univariable analysis. These associations remained robust even after adjusting for confounding factors, including age, sex, body mass index, original kidney disease, history of cardiovascular disease, smoking habits, systolic blood pressure, hemoglobin level, serum levels of albumin, low-density lipoprotein cholesterol, and C-reactive protein, urinary protein-to-creatinine ratio, estimated GFR (eGFR), and GMR.

Conclusion

BMG is an independent factor associated with CI (executive dysfunction) independent of kidney dysfunction and brain atrophy.