Early detection of aminoglycoside nephrotoxicity with urinary beta-2-microglobulin.
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.
D000328:Adult; D000368:Aged; D000617:Aminoglycosides / Q000009:adverse effects* / Q000627:therapeutic use; D001609:Beta-Globulins / Q000652:urine*; D006801:Humans; D007239:Infections / Q000188:drug therapy; D007674:Kidney Diseases / Q000139:chemically induced; D007684:Kidney Tubules / Q000187:drug effects*; D008875:Middle Aged; D001613:beta 2-Microglobulin / Q000652:urine*
D000617:Aminoglycosides; D001609:Beta-Globulins; D001613:beta 2-Microglobulin