Evaluation and comparison of serum level of IgAanti-b2-glycoproteinI in hemodialysis and peritoneal dialysis patients

Abstract

IgA autoantibodies against (β2-glycoproteinI (β2-GPI) are linked with cardiovascular and thrombotic events and death in patients with chronic kidney disease (CKD). Identification of risk factors can improve management strategies. The aim of this study was to compare the levels of these antibodies in patients undergoing hemodialysis and peritoneal dialysis. Methods. The presence of anti-β2-GPI IgA auto-antibodies was evaluated in a cohort of 115 patients under hemodialysis (HD, n= 73) and peritoneal dialysis (PD, n=42). Moreover, retrospective data on the incidence of myocardial infarction and cerebrovascular accident (CVA), arteriovenous fistula (AVF) failure, and history of peritonitis were analyzed. Results. Forty-six (40%) of patients were positive for IgA-aβ2-GPI with median levels of 74.95 U/mL (IRQ = 47.27). anti-IgA-aβ2-GPIantibodies titer was higher in HD than PD group [median 76.35 (47) vs. 63.85 (56.35)]; however, it was statistically insignificant (p = 0.721). AVF thrombosis occurred in 12% and 28.6% of patients in HD and PD, respectively (p = 0.030). There was no significant difference between AVF failure and lgA-aP2-GPI positivity (p = 0.0901). Sixty-one percent of PD patients had a history of peritonitis, 21.4% (n = 9) of which were positive for IgA-aβ2GPI (p = 0.554). Positive lgA-aP2-GPI increased the risk of thrombotic events (CVA and MI) (OR= 2.43, CI: 0.65-9.17. p = 0.18), it was not statistically significant though.