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INCREASED SERUM β2 MICROGLOBULIN DURING REJECTION, CYCLOSPORINE‐INDUCED NEPHROTOXICITY, AND CYTOMEGALOVIRUS INFECTION IN RENAL TRANSPLANT RECIPIENTS

In 83 renal transplant recipients, serum β2 microglobulin (β2m) levels were significantly elevated during pretransplant uremia, rejection, cyclosorine-induced nephrotoxicity, and infections. In patients with normal serum creatinine, 74% had elevated serum β2m levels. None of the cyclosorine-treated patients had normal levels of β2m. Patients with stable renal allograft function receiving cyclosporine showed significantly higher serum β2m (P<0.001) and serum creatinine (P<0.01) levels than azathioprine treated patients. Patients with an irreversible rejection showed significantly higher serum concentrations of β2m than patients experiencing a reversible rejection (P<0.001). During cytomegalovirus (CMV) infection the serum β2m levels were elevated compared with other infections (P<0.001), while the serum creatinine was not. However, infected patients had higher serum levels of β2m and creatinine than patients with stable renal allograft function (P<0.001). Serum β2m may thereofore be useful in the early diagnosis of CMV infection. To conclude, serum β2m levels cannot distinguish between rejection, cyclosporine nephrotoxicity, or infection.