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Renal handling of beta 2-microglobulin in patients with cystic fibrosis
G L Kearns1, P L Berry, J A Bocchini
1Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock.
Abstract:
We evaluated the renal handling of beta 2-microglobulin (beta 2-M) and creatinine in healthy outpatients (n = 6), normal children hospitalized for infections treated with antibiotics (not including an aminoglycoside) (n = 4); outpatients with cystic fibrosis (CF; n = 12), and hospitalized patients with CF (n = 6) who received a 10- to 14-day course of antibiotic treatment that included an aminoglycoside. The serum beta 2-M concentrations in the normal outpatients (2020.1 +/- 276.6 micrograms/L) were significantly lower (p less than 0.05) than those observed for outpatients (2833.3 +/- 202.6 micrograms/L) or patients with CF (2861.8 +/- 340.5 micrograms/L. There were no significant differences found for creatinine clearance or fractional excretion of beta 2-M when subjects without CF were compared with those with the disease. Furthermore, no significant differences were observed in hospitalized patients with CF when creatinine clearance and fractional excretion of beta 2-M were compared between the initiation and conclusion of aminoglycoside treatment. Glomerular filtration and proximal tubular reabsorption of beta 2-M were not altered in patients with CF. These findings do not support a global defect in proximal renal tubular reabsorption as the underlying cause for altered aminoglycoside clearance in patients with CF.
Insights
This study found that serum beta 2-microglobulin (beta 2-M) levels are higher in cystic fibrosis (CF) patients. Renal handling of beta 2-M and creatinine is not altered in CF, refuting a proximal tubular defect.
Area of Science:
- Nephrology
- Pediatrics
- Pharmacology
Background:
- Cystic Fibrosis (CF) is a genetic disorder affecting multiple organs, including the kidneys.
- Aminoglycoside antibiotics are commonly used to treat CF pulmonary exacerbations.
- Altered aminoglycoside clearance in CF patients suggests potential renal dysfunction.
Purpose of the Study:
- To investigate the renal handling of beta 2-microglobulin (beta 2-M) and creatinine in patients with CF.
- To determine if proximal renal tubular dysfunction contributes to altered aminoglycoside clearance in CF.
Main Methods:
- Comparative analysis of serum beta 2-M, creatinine clearance, and fractional excretion of beta 2-M.
- Study included healthy outpatients, hospitalized children with infections, and CF patients (outpatient and hospitalized).
- Hospitalized CF patients were assessed before and after aminoglycoside treatment.
Main Results:
- Serum beta 2-M concentrations were significantly higher in CF outpatients and hospitalized CF patients compared to healthy controls.
- No significant differences in creatinine clearance or fractional excretion of beta 2-M were found between CF and non-CF subjects.
- No significant changes in renal parameters were observed in hospitalized CF patients during aminoglycoside treatment.
Conclusions:
- Glomerular filtration and proximal tubular reabsorption of beta 2-M are not impaired in CF patients.
- The findings do not support a global defect in proximal renal tubular reabsorption as the cause of altered aminoglycoside clearance in CF.