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β2-Microglobulin – reappraisal of an alternative to creatinine in assessment of kidney function in children with urinary tract malformations (Abstract)

Kolja Kvist¹, Henrik Gutte², Jorgen Thorup¹,³
¹Department of Paediatric Surgery , Rigshospitalet, Copenhagen, Denmark
²Department of Clinical Physiology, Nuclear Medicine and PET, 
Rigshospitalet, Copenhagen, Denmark.
³Department of Paediatric Surgery, Rigshospitalet and Faculty of Health Science, University of Copenhagen, Denmark 


Objective: To evaluate serum β-microglobulin as an alternative estimator of the glomerular filtration rate (GFR) in children.
Patients and methods: 111 children between the age of 1 and 178 months (mean 43 months) with congenital urinary tract abnormalities were included. They were divided into 3 age-groups, each analysed separately. 51Cr-ethylenediaminetetraacetic acid (51Cr-EDTA) plasma clearence and simultaneous measurements of serum creatinine and serum ß 2-microglobulin were
done. 51Cr-EDTA plasma clearance served as gold standard. The results were analysed using receiver operating curves (ROCcurves), kappa statistics, and McNermars β test, as well as sensitivity, specificity, and positive and negative predictive value.
Results: Serum β2 2-microglobulin was more sensitive (0.75 – 1.00) than serum creatinine (0.11–0.47), and the difference became more attenuated the yournger the child. Also the kappa values and ROC-curves indicated  a closer approximation between β 2-microglobulin and 51Cr-EDTA. However, serum creatinine had higher specificity, and McNermars β test confirmed that the observed differences were significant.
Conclusion: β-microglobulin is a better estimator of GFR in children than serum creatinine, and the difference is enhanced the younger the child. The higher sensitivity and negative predictive value makes it useful as a screening parameter, since a normal value with high accuracy attests a normal GFR.


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