Early detection of aminoglycoside nephrotoxicity with urinary beta-2-microglobulin
Schentag, J.J.; Sutfin, T.A.; Plaut, M.E.; Jusko, W.J.
Journal of Medicine 9(3): 201-210
1978
ISSN/ISBN: 0025-7850 PMID: 84037 Document Number: 127436
We used a radioimmunoassay to evaluate the changes in the urinary excretion of beta2-microglobulin (beta2M) in 21 patients receiving aminoglycosides for treatment of infection. Excretion of this protein rose to a peak at least 5 times the baseline value in the urine, and declined rapidly to control values after drug administration ceased. In six patients who developed aminoglycoside nephrotoxicity, urinary beta2M excretion rose 5 days or more before serum creatinine rose, and 5 of 6 nephrotoxic patients excreted more than 50 mg/day (normal, less than 0.1 mg/day). Urinary beta2M is a non-specific indication of renal tubular damage, but heralds aminoglycoside-induced damage before standard tests of kidney function change.