DIAGNOSTIC PERFORMANCE OF BETA-2-MICROGLOBULIN COMPARED WITH TRADITIONAL MARKERS IN DETECTING EARLY KIDNEY DISEASE AMONG ELDERLY PATIENTS AT ALEX EKWUEME FEDERAL UNIVERSITY TEACHING HOSPITAL, ABAKALIKI.

 

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https://storage.unitedwebnetwork.com/files/1099/832b2f1d6bc2f7116210ebb996bc3a7f.pdf
DIAGNOSTIC PERFORMANCE OF BETA-2-MICROGLOBULIN COMPARED WITH TRADITIONAL MARKERS IN DETECTING EARLY KIDNEY DISEASE AMONG ELDERLY PATIENTS AT ALEX EKWUEME FEDERAL UNIVERSITY TEACHING HOSPITAL, ABAKALIKI.

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Ugochi
Onu
Anthony Agbo tonyagbo@gmail.com Alex-Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria Department of Medicine Abakaliki Nigeria -
Ngozi Ifebunandu ngifebunandu@yahoo.com Alex-Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria Department of Medicine Abakaliki Nigeria -
Olaronke Afolabi afolaronke2020@gmail.com Alex-Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria Department of Medicine Abakaliki Nigeria -
Ugochi Onu ugochionu2008@gmail.com University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria Department of Medicine Enugu Nigeria *
Monday Nwobodo ume26011970@gmail.com Alex-Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria Department of Medicine Abakaliki Nigeria -
Chinedu Udeze chynedu2001@gmail.com Alex-Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria Department of Medicine Abakaliki Nigeria -
Christiana Ologwu chinyeretina02@gmail.com Alex-Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria Department of Medicine Abakaliki Nigeria -
Onyinye Nwikwu onyinyenwikwu@gmail.com Alex-Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria Department of Medicine Abakaliki Nigeria -
Ifeoma Ulasi ifeomaulasi@yahoo.co.uk University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria Department of Medicine Enugu Nigeria -
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Chronic kidney disease (CKD) is a growing global health burden, particularly in ageing populations. Early detection and initiation of appropriate management are key to halting progression to kidney failure.  Conventional biomarkers such as serum creatinine and urine albumin-to-creatinine ratio (UACR) are limited by dependence on muscle mass and other physiological variables. Beta-2-microglobulin (β₂M) has emerged as a potential alternative marker of kidney function, relatively unaffected by age, sex, or muscle mass.

Objective:To evaluate the diagnostic performance of serum β₂M compared with traditional markers (creatinine and UACR) in the early detection of CKD among elderly patients.


Methods: This hospital-based cross-sectional study involved 192 (96 CKD and 96 controls) age- and sex-matched participants aged ≥60 years. Spot urine UACR, serum β₂M, and creatinine were measured. Estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI (2021) equation. Data analysis was done using SPSS version 21-Amonk, NY, USA

The study mean age was 67.64 ± 6.99 (CKD = 67.6 ± 7.0, controls = 66.2 ± 5.9) years. β₂M demonstrated a sensitivity of 82.7%, 79.0% specificity, 82.3% positive predictive value (PPV), and 79.4% negative predictive value (NPV), with an optimal diagnostic cut-off of 2.79 mg/L. These are comparable to sensitivity of 84.6% and 79.8%, specificity of 72.0% and 74.0%, PPV of 78.1% and 78.4%, and NPV of 79.8% and 75.6% for UACR and serum creatinine, respectively. ROC analysis showed AUCs of 0.860 for β₂M, 0.851 for UACR, and 0.837 for creatinine. β₂M correlated strongly with UACR (r = 0.89, p < 0.001) and inversely with eGFR (r = –0.68, p < 0.001).


Serum β2M is a promising biomarker for assessing kidney function in the elderly, offering diagnostic performance comparable to traditional markers. The study identified a β2M cut-off value of 2.79 mg/L as optimal for early detection of kidney impairment. Incorporating β2M measurement alongside conventional tests may enhance early CKD diagnosis and management, and its use is recommended either as a standalone test or as part of a diagnostic panel.

Kewords