Imperium Académico Multidisciplinary Journal · Mar 11, 2026
The role of B2M in the early diagnosis of chronic kidney disease (ERC): a systematic review and meta-analysis in 6 378 patients
By Mieles DFQ, Castro CXC, Castro RMO et al.
Introduction: Chronic kidney disease (CKD) affects more than 10% of the global population and represents one of the leading causes of mortality worldwide. Early detection is crucial, particularly in older adults, since serum creatinine loses diagnostic sensitivity in this population. β2-microglobulin (β2-M), being independent of muscle mass and reflecting early proximal tubular injury, has been proposed as a complementary biomarker to creatinine. Objective: To evaluate the diagnostic accuracy of β2-microglobulin (β2-M) for the early detection of CKD in adults. Methods: A systematic review (SR) and meta-analysis (MA) were conducted using bibliographic databases including PubMed, Scopus, and ScienceDirect (2014–2024). Randomized controlled trials (RCTs), cohort studies, and cross-sectional studies reporting β2-M levels (mg/L) and glomerular filtration rate (GFR) were included. Data were analyzed using random-effects models with restricted maximum likelihood estimation (REML) and Hartung-Knapp-Sidik-Jonkman correction. Heterogeneity was assessed using the I² statistic. Results: A total of 2,778 articles were screened; 15 were included in the systematic review and 7 in the meta-analysis. The pooled sample comprised 6,378 participants (3,190 with CKD and 3,188 without CKD). The prevalence of CKD among individuals with elevated β2-M was 41%. The pooled relative risk (RR) was 3.25 (95% CI: 1.68–6.29; p=0.005). Patients with elevated β2-M levels had approximately three times the risk of developing CKD compared with those with normal values. High heterogeneity was observed among the analyzed populations (I² = 96%). Moderate variability (Tau² = 0.41) suggests partial consistency of the estimated effect. The association between β2-M and CKD is consistent and physiologically plausible, as elevated β2-M levels predict renal deterioration and mortality in clinical settings. Additionally, β2-M may complement traditional renal biomarkers such as creatinine and cystatin C. Conclusion: β2-microglobulin is a promising biomarker for the early diagnosis of CKD; however, it should be used as a complementary marker within the standard renal function assessment panel.