Abstract
The handling of β2μ was studied in 19 renal transplant recipients, aged 2 to 18 yr, to find an improved method to identify rejection and separate it from other causes of renal failure. Serum β2μ concentrations, measured daily, usually increased 24 to 48 h before serum creatinine (Scr) increased in patients undergoing transplant rejection. In addition, being poorly dialyzable, serum β2μ was superior to Scr in demonstrating changes in GFR in transplant recipients requiring dialysis post transplant.
β2μ is reabsorbed almost completely from tubular fluid in the normal proximal tubule making urinary excretion of β2μ a good indicator of proximal tubule function. Fractional excretion (FE) of β2μ was followed daily in transplant recipients. Most values were elevated, especially in the first 4 days after transplantation, a time when acute tubular necrosis (ATN) is expected. Values also rose in several patients 3 to 7 days after rejection had been established. This is consistent with the thesis that acute rejection may be complicated by ATN which may persist after rejection is reversed by steroid pulses. The study demonstrates that daily measurement of serum β2μ is a valuable adjunct in the management of renal transplant recipients, also that measurement of FE of β2μ has the potential of distinguishing rejection from ATN in transplant recipients, helping to determine the need for treatment with steroid pulses. Measurement of FE is superior to measurement of urinary concentration of β2μ for this purpose.
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Narayanan, M., Peterson, L. & Robson, A. 1528 β2 MICROGLOBULIN (β2μ) IN RENAL TRANSPLANT RECIPIENTS. Pediatr Res 15 (Suppl 4), 698 (1981). https://doi.org/10.1203/00006450-198104001-01551
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DOI: https://doi.org/10.1203/00006450-198104001-01551