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Zur Früherkennung der diabetischen Nephropathie: Beta2-Mikroglobulin im Serum

Early detection of diabetic nephropathy: Serum Beta2-microglobulin

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Summary

Detection of early diabetic nephropathy is necessary to postpone or even prevent progression of irreversible kidney damage by therapeutic measures. Beta2-microglobulin (β2-MG) as a parameter of the glomerular filtration rate has been measured by immunoassay in the serum of 100 diabetic subjects, 50 insulin-dependent (IDD), and 50 noninsulin-dependent (NIDD) patients. The results are compared with endogenous creatinine-clearance, serum creatinine concentration, and proteinuria and are related to different stages of diabetic retinopathy (RD). Normal values were obtained from 50 healthy age- and sex-matched subjects.

A close correlation was found between β2-MG levels and endogenous creatinine clearance. Thirty-nine diabetics revealed an elevated β2-MG (2.5 mg/l or higher), only 16 of whom had increased serum creatinine levels (1.4 mg/dl or higher). Significant differences of β2-MG were obtained between each group of patients with different stages of RD. A relevant difference of serum creatinine was found only between patients with normal eye fundus and advanced proliferative retinopathy, respectively. Without RD 26% of the patients revealed elevated β2-MG but normal creatinine values demonstrating a “latent nephropathy”, just 8% showed an increase of both parameters. Of the diabetics with proliferative retinopathy 40% suffered from impaired kidney function proven by reduced creatinine clearance and by elevation of β2-MG and creatinine as well, 15% just revealed an increase of β2-MG with normal creatinine levels. The incidence and extent of nephropathy demonstrated by pathologic values of both β2-MG and serum creatinine were significantly higher in IDD patients with a smaller proportion of “latent nephropathy” as compared to NIDD patients (p<0.02). This is also true for the markedly increased proteinuria in IDD subjects. In both groups, measurement of β2-MG disclosed more often decrease of renal function in diabetics than did concentrations of serum creatinine.

The determination of serum β2-MG appears to be a reliable and sensitive method for the early detection of minor impairment of kidney function in diabetes mellitus.

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Authors and Affiliations

  1. Medizinische Poliklinik und Augenklinik der Universität München, Germany

    F. -D. Goebel, T. Schmeidl, H. S. Füeßl & S. Vogel

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  1. F. -D. Goebel
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  2. T. Schmeidl
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  3. H. S. Füeßl
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  4. S. Vogel
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Herrn Prof. Dr. N. Zöllner zum 60. Geburtstag gewidmet

Unterstützt durch die Deutsche Forschungsgemeinschaft (Go 299/2)

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Goebel, F.D., Schmeidl, T., Füeßl, H.S. et al. Zur Früherkennung der diabetischen Nephropathie: Beta2-Mikroglobulin im Serum. Klin Wochenschr 61, 1209–1215 (1983). https://doi.org/10.1007/BF01537432

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  • DOI: https://doi.org/10.1007/BF01537432

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