Urinary excretion of β2-microglobulin as a prognostic marker in immunoglobulin A nephropathy

Korean J Intern Med. 2014 May;29(3):334-40. doi: 10.3904/kjim.2014.29.3.334. Epub 2014 Apr 29.

Abstract

Background/aims: β2-microglobulin (β2-MG) is freely filtered at the glomerulus and subsequently reabsorbed and catabolized by proximal renal tubular cells. Urinary β2-MG is an early and sensitive biomarker of acute kidney injury; however, its utility as a biomarker of immunoglobulin A nephropathy (IgAN) is unclear.

Methods: We included urinary β2-MG levels in the routine laboratory examination of all inpatients with biopsy-proven IgAN at our hospital from 2006 to 2010. We retrospectively analyzed the correlation between β2-MG levels and clinical parameters as a prognostic biomarker of IgAN.

Results: A total of 51 patients (30 males, 21 females; mean age, 33.01 ± 12.73 years) with IgAN were included in this study. Initial demographic, clinical, and laboratory data for all patients are listed. The mean initial estimated glomerular filtration rate and 24-hour urine protein levels were 94.69 ± 34.78 mL/min/1.73 m(2) and 1.28 ± 1.75 g/day, respectively. The mean level of urinary β2-MG was 1.92 ± 7.38 µg/mg creatinine. There was a significant correlation between initial serum creatinine (iSCr), urine protein creatinine ratio (UPCR), and the level of β2-MG (r = 0.744, r = 0.667, p < 0.01). There was also a significant correlation between renal function tests and the level of urinary β2-MG (p < 0.01). Cox regression analysis showed that albumin, β2-MG, iSCr, and UPCR were significant predictors of disease progression in IgAN.

Conclusions: Urinary β2-MG levels showed a significant correlation with renal function and proteinuria in IgAN. Thus, we propose that urinary β2-MG may be an additional prognostic factor in patients with IgAN.

Keywords: Glomerulonephritis, IGA; Prognostic factor; Urinary β2-microglobulin.

MeSH terms

  • Adult
  • Biomarkers / blood
  • Biomarkers / urine
  • Biopsy
  • Creatinine / blood
  • Creatinine / urine
  • Disease Progression
  • Female
  • Glomerular Filtration Rate
  • Glomerulonephritis, IGA / blood
  • Glomerulonephritis, IGA / diagnosis
  • Glomerulonephritis, IGA / physiopathology
  • Glomerulonephritis, IGA / urine*
  • Humans
  • Inpatients
  • Linear Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Predictive Value of Tests
  • Prognosis
  • Proportional Hazards Models
  • Proteinuria / blood
  • Proteinuria / diagnosis
  • Proteinuria / physiopathology
  • Proteinuria / urine*
  • Risk Factors
  • Young Adult
  • beta 2-Microglobulin / urine*

Substances

  • Biomarkers
  • beta 2-Microglobulin
  • Creatinine