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Paper Information

Journal:   RESEARCHER BULLETIN OF MEDICAL SCIENCES (PEJOUHANDEH)   2003 , Volume 8 , Number 3 (33); Page(s) 227 To 232.
 
Paper: 

URINARY Β2-MICROGLOBULIN IN VARIOUS GRADES OF VESICOURETERAL REFLUX

 
 
Author(s):  SHARIFIAN M.*, JAR ELAHI A., BAGHAEIPOUR M.R., MEHRABI YAD ELAH
 
* Department of Pediatric nephrology, Shaheed Beheshti University of Medical Sciences
 
Abstract: 

Background: Reflux nephropathy is leading cause of end stage renal disease (ESRD) around the world. Vesicoureteral reflux (VUR) is present in about one percent of normal children. This comprises 30-70% children with urinary tract infection (UTI) ad up to 40-50% of their siblings. To examine whether urinary β2-microglobulin (β2MG) can be used as a screening test for VUR, it was measured in random urine samples in 47 patients with various grades of reflux and 36 non-refluxing children.
Material and Methods: β2 microglobulin and creatinine were measured in 83 random urine samples obtained at the time of Voiding Cysto Ureterography (VCUG). Fifty five patients were females of whom 31 patients had VUR and of 28 males, 16 had reflux. Β2 MG was measured using radio immunoassay method and the creatinine by spectrophotometry and recorded as microgram per mg creatinine.
Results: The mean β2MG/Cr was higher in the reflux-group (3.45±7.97) than non-reflux-group (0.23±0.24) (P=0.01). The mean Β2 MG/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). Maximum β2MG/Cr was detected in patients with grade 4 VUR (33.3) and the minimum was zero in non refluxing patients. No significant difference was present in Β2MG/Cr values in patients with VUR Grade 1,2 and 3 and non refluxing patients (0.21±0.7, 1.21±0.18 and 0.23±0.24, respectively. No patient in the non-reflux-group had Β2MG/Cr higher than 0.85. There was no significant difference in Β2MG/Cr in patients with bilateral (4.94±9.91) and unilateral (1.91±5.9) reflux.
Conclusion: This study revealed that the maximum Β2MG/Cr value in non-refluxing children was 0.85 microgram/mg Cr. Higher values can be considered a cut off point in screening children for VUR. The study also revealed that patient with higher graded reflux have very high Β2MG/Cr values and this can be considered and prognostic factor for progression to renal failure. The correlation between urinary β2-microglobulin and renal scars should be considered in future studies.

 
Keyword(s): Β2- MICROGLOBULIN, VESICOURETERAL REFLUX, URINARY TRACT INFECTION, CHILDREN
 
References: 
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