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Iranian Journal of Pediatrics
Tehran University of Medical Sciences Press
ISSN: 1018-4406
EISSN: 2008-2150
Vol. 16, No. 3, 2006, pp. 277-282
Bioline Code: pe06036
Full paper language: Farsi
Document type: Research Article
Document available free of charge

Iranian Journal of Pediatrics, Vol. 16, No. 3, 2006, pp. 277-282

 en Urinary Beta 2 microglobulin in various grades of renal scar in pyelonephritis in children
Sharifian, M; Anvaripour, N & Karimi, A


Background: For patients who have renal involvement during urinary infection or children with Vesico-ureteral Reflux (VUR), renal Dimercaptosuccinic Acid (DMSA) scan is performed which exposes children to significant radiation. β2MG is a low molecular weight protein freely filtered by the glomeruli and then actively reabsorbed normally up to 99.9% in the proximal tubules; its urinary measurement is a good index of proximal tubular function of these cells as a primary screening test.
Methods: Urinary β2MG/Cr was measured in random urine samples in 53 pyelonephritis patients. Urine samples were obtained at the time of Voiding Cysto-Ureterography (VCUG). DMSA renal scan was performed in all patients. β2MG and urine creatinine were tested by ELISA and autoanalyzer, respectively.
Findings: Twenty children had various grades of renal scar. Results were compared with ratios of 19 children with low uptake scanning and with 14 normal scanning. The mean urinary β2MG/Cr was higher in the scarring group (5.23±10.6) than in the normal group (0.19±0.2) and in low uptake group (0.49±0.86). Patients with grade 3 had higher values (14.69± 15.82) than grades 1 (0.36± 0.35) and 2 (3.37± 5.2). Patients without renal scar had β2MG/Cr ratio below 0.46 microgram/mg. The mean β2MGMG was higher in the VUR group (3/45± 7.97) than non-VUR group (0.23 ± 0.24) ug/mgCr (P= 0.01). The mean β2MG/Cr was higher in patients with VUR grades 4 and 5 (8.93±12.01) than patients with VUR grades 1 to 3 (0.81± 3.04) (P= 0.02).
Conclusion: This study revealed that the maximum B2MG/Cr value in non-VUR children was 0.85 microgram/mgCr, higher values can be considered as a cut off point in screening children for VUR. Measurement of Urinary B2MG may be useful in the early detection of tubular damage in VUR patients and patients with renal scars.

Beta 2 microglobulin , Renal scar , Pyelonephritis Children , Vesico-ureteral reflux

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