Albumin and beta 2-microglobulin radioimmunoassays applied to monitoring of renal-allograft function and in differentiating glomerular and tubular diseases.

Abstract

Blood and urine were samples daily from 11 renal-allograft recipients from one to six weeks after the transplant. Clearances of both albumin (Calb) and beta2-microglobulin (C beta 2 mu) were significantly increased in all 11 patients. Five patients (Group I) with acute allograft rejection showed markedly increased Calb and moderately increased C beta 2 mu, concurrent with decreased creatinine clearance (CCr). Five other patients (Group II) with no evidence of rejection demonstrated episodes of grossly increased C beta 2 mu with minimally increased but stable Calb and normal CCr. One patient had no evidence of rejection nor indications of glomerular or tubular proteinuria. While changes in serum beta 2-microglobulin concentration closely paralleled those of serum creatinine in the Group II patients, the results diverged in the Group I patients because the increase in serum beta 2-microglobulin exceeded that of serum creatinine and preceded the increased in creatinine by one to five days, suggesting that measurement of serum beta 2-microglobulin might afford earlier indication of the nature and extent of renal damage in the allograft recipients.

High Serum Level ofβ2-Microglobulin in Late Posttransplant Period Predicts Subsequent Decline in Kidney Allograft Function: A Preliminary Study

“…Other authors stated that serum β 2MG estimated GFR even more accurately compared to serum creatinine [ 15 , 20 , 21 ]. Woo et al [ 33 ] concluded that the increase of serum β 2MG concentration evidenced a glomerular pathology, which has recently been recognized as the main cause of chronic allograft dysfunction [ 6 ]. Meanwhile, observed weak correlation ( r = 0.466) between serum β 2MG and creatinine (though their sieving coefficients are close to unity [ 33 ]) suggests that another reason for the increase of serum β 2MG concentration might be transplant complications and comorbidities leading to an increase of β 2MG synthesis.…”

Clinical significance of beta-2-microglobulin, enzymes, cytokines in serum and urine in patients with chronic renal allograft dysfunction

“…Serum β2-МG concentration statistically correlated to lesser degree with serum creatinine concentration (r = 0.51 p < 0.05), urine β2-МG concentration (r = 0.53, p<0.05), with GFR (r = -0.44, p < 0.05), proteinuri (r = 0.50, p < 0.05) and urine density (r = -0.41, p<0.05) allowing explain its increase by glomerular RAT pathology [5] at which the filtration process undergoes changes. At the same time, very weak correlation between β2-МG and creatinine allows assume that another cause of increased blood serum β2-MG concentration in the patients with chronic RAD was the increase of its extrarenal synthesis that was found earlier by other authors [31].…”

“…Correlation analysis has shown interdependence between blood serum β2-МG and ІL-10 concentrations (r = 0.56, p < 0.05). In view of the literature data showing that β2-MG and IL-10 are secreted by the lymphocytes in the peripheral blood [1,5,11,19,31], it is possible to assume that the cause of chronic RAD in this case is antibody-mediated rejection.…”

“…One of the methods of laboratory kidney function diagnostic is the estimation of blood concentration and urine excretion of the low-molecular proteins such as beta-2-microglobulin (β2-MG) [12,31]. Such estimation can reveal respectively the degree of injury of the glomerula basal membrane of the glomerules and of the epithelium of the proximal channels [7,10,31].…”

“…One of the methods of laboratory kidney function diagnostic is the estimation of blood concentration and urine excretion of the low-molecular proteins such as beta-2-microglobulin (β2-MG) [12,31]. Such estimation can reveal respectively the degree of injury of the glomerula basal membrane of the glomerules and of the epithelium of the proximal channels [7,10,31]. According to some authors, measurement of blood serum β2-MG concentration compared to the glomerular filtration rate (GFR) is a more accurate estimation of the blood serum β2-MG compared to GFR, especially at its low meanings, allowing assess kidney function [7,15].…”