beta 2-Microglobulin instability in pathological urine

Urinary excretion of beta 2-microglobulin (beta 2M) is a widely used test of renal proximal tubular function. beta 2M is known to be unstable in normal urine with a pH less than 5.5. The results of a study of beta 2M excretion in patients receiving gentamicin suggested that beta 2M might be more unstable in pathological urine. A series of experiments was designed to define the extent, variability, and mechanism of its instability in pathological urine. It was unstable in pathological urine with a pH of 6.0 at 37 degrees C and pH 5.5 at room temperature, but this varied in urines from different patients. The instability was abolished by heating the urine to 80 degrees C. These results suggest that the most likely explanation for the instability is enzymic degradation. Because enzymuria will vary among patients, investigators should test the stability of beta 2M in urine from the patients they wish to study before trying to define conditions for urine collection.