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Analysis of the ratio of urinary beta-2-microglobulin to total protein concentration in children with isolated tubulointerstitial disease

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Abstract

Background

Proteinuria is broadly classified into glomerular and tubular proteinuria. Urinary beta-2-microglobulin (β2-MG) is known as a marker for detecting tubulointerstitial diseases. However, tubulointerstitial damage can also lead to an increase in urinary β2-MG level in some patients with glomerular diseases. This study aimed to determine the ratio of urinary β2-MG to total protein (TP) concentration in patients with both isolated tubulointerstitial and glomerular disease.

Methods

This multicenter, retrospective study included children with Dent disease or lupus nephritis in five facilities. Their urinary β2-MG levels were > 1000 µg/L. Urinary β2-MG and TP concentrations were obtained, and the ratio of urinary β2-MG to TP concentration (µg/mg) was calculated. The Mann–Whitney U test was performed to compare this ratio between these children. The optimal cutoff value of the ratio for considering the presence of glomerular disease was obtained from the receiver operating characteristic (ROC) curve.

Results

We obtained information on 23 children with Dent disease and 14 children with lupus nephritis. The median ratios of urinary β2-MG to TP concentrations in children with Dent disease and lupus nephritis were 84.85 and 1.59, respectively. The ROC curve yielded the optimal cutoff value of this ratio for distinguishing between these diseases, and the cutoff value was found to be 22.3.

Conclusion

In children with tubulointerstitial diseases, the urinary β2-MG concentration may be approximately 8.5% of the TP concentration. The possibility of presenting with glomerular disease should be considered in patients with a ratio of urinary β2-MG to TP concentration of < 22.3 (µg/mg).

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Data availability

The datasets are available from the corresponding author upon reasonable request.

Change history

  • 11 May 2023

    The original version is updated due to spell error "microgobulin" which appeared inadvertently in the Article title, Abstract and keywords.

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Funding

No funding was received for conducting this study.

Author information

Authors and Affiliations

  1. Department of Nephrology, Aichi Children’s Health and Medical Center, 7-426 Morioka-cho, Obu, Aichi, 474-8710, Japan

    Tatsuya Nishimura, Satoshi Hibino, Kazuki Tanaka & Naoya Fujita

  2. Ichinomiya Medical and Habilitation Center, 1679-2 Tomida-nagaresuji, Ichinomiya, Aichi, 494-0018, Japan

    Osamu Uemura

  3. Department of Infection and Immunology, Aichi Children’s Health and Medical Center, 7-426 Morioka-cho, Obu, Aichi, 474-8710, Japan

    Naomi Iwata

  4. Department of Pediatrics, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu, Shizuoka, 430-8558, Japan

    Masaki Yamamoto

  5. Department of Pediatric Nephrology, Gifu Prefectural General Medical Center, 4-6-1 Noishiki, Gifu, Gifu, 500-8717, Japan

    Eiji Matsukuma

  6. Department of Pediatrics, Ichinomiya Municipal Hospital, 2-2-22 Bunkyo, Ichinomiya, Aichi, 491-8558, Japan

    Yoshishige Miyake

  7. Department of Pediatric Nephrology, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital, 2-9 Myoken-Cho Showa-ku, Nagoya, Aichi, 466-8650, Japan

    Yoshimitsu Gotoh

  8. Department of Pediatrics, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan

    Tatsuya Nishimura

Authors
  1. Tatsuya Nishimura
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  2. Osamu Uemura
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  3. Satoshi Hibino
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  4. Kazuki Tanaka
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  6. Masaki Yamamoto
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  7. Eiji Matsukuma
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  8. Yoshishige Miyake
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  9. Yoshimitsu Gotoh
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  10. Naoya Fujita
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by TN, OU, and SH. The first draft of the manuscript was written by TN, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Tatsuya Nishimura.

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Conflict of interest

The authors declare that there are no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee at which the studies were conducted (IRB approval number: 2018038) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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As only existing data were used, the requirement for informed consent was waived, but we provided information about this research and a means to opt out.

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Nishimura, T., Uemura, O., Hibino, S. et al. Analysis of the ratio of urinary beta-2-microglobulin to total protein concentration in children with isolated tubulointerstitial disease. Clin Exp Nephrol 27, 701–706 (2023). https://doi.org/10.1007/s10157-023-02349-7

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  • DOI: https://doi.org/10.1007/s10157-023-02349-7

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