Dataset Information

Comparison of 2 Serum-Free Light-Chain Assays in CKD Patients.

ABSTRACT: Introduction:Quantification of serum-free light chains (FLCs) is important in the diagnosis and monitoring of paraprotein-related diseases. There are currently 2 FLC assays available: the Freelite assay (Binding Site) and the N Latex assay (Siemens). There is emerging evidence that these assays give different results, but it is not established how kidney dysfunction affects these assays differently. Methods:In this study, we measured and compared serum FLCs in patients with mild-to-moderate chronic kidney disease (CKD) using both assays. Results:Although ? FLCs are higher by Freelite, ? FLCs are higher by N Latex. Both ? and ? FLCs correlate inversely with estimated glomerular filtration rate (eGFR) in the 2 assays, but this effect is more pronounced in ?-free light-chain measurement by N Latex. Consequently, although the ?/? ratio by Freelite is inversely correlated by eGFR, the ?/? ratio by N Latex is positively correlated with eGFR. Conclusion:Our results clearly demonstrate that the 2 available FLC assays cannot be used interchangeably in patients with CKD.

SUBMITTER: Sprangers B

PROVIDER: S-EPMC7210599 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Comparison of 2 Serum-Free Light-Chain Assays in CKD Patients.

Sprangers Ben B Claes Kathleen K Evenepoel Pieter P Kuypers Dirk D Poesen Koen K Delforge Michel M Bossuyt V Xavier X Meijers Björn B

Kidney international reports 20200130 5

<h4>Introduction</h4>Quantification of serum-free light chains (FLCs) is important in the diagnosis and monitoring of paraprotein-related diseases. There are currently 2 FLC assays available: the Freelite assay (Binding Site) and the N Latex assay (Siemens). There is emerging evidence that these assays give different results, but it is not established how kidney dysfunction affects these assays differently.<h4>Methods</h4>In this study, we measured and compared serum FLCs in patients with mild-t ...[more]

PMID: 32405584

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Project description:Background and objectivesHigh levels of serum polyclonal combined Ig free light chains are associated with inflammation and decreased excretory kidney function, and they are an independent risk factor for mortality. Whether combined Ig free light chain predicted mortality and progression to ESRD in a stages 3-5 CKD cohort was assessed.Design, setting, participants, & measurementsThis was a prospective cohort study of 872 patients with stages 3-5 CKD (nondialysis) recruited into the Chronic Renal Insufficiency Standards Implementation Study. Patients were recruited to the Chronic Renal Insufficiency Standards Implementation Study in an unselected manner from secondary care nephrology clinics between 2004 and 2010. Combined Ig free light chain was measured at recruitment and analyzed by quartiles. The cohort was followed up for a median of 41.4 months (interquartile range =28.3-68.0 months). Cox regression analysis was undertaken to determine the variables associated with mortality and progression to ESRD.ResultsCombined Ig free light chain quartiles were <49.4, 49.4-68.8, 68.9-100.7, and >100.7 mg/L. An independent association with death and progression to ESRD was associated with the third and fourth combined Ig free light chain quartiles (quartile 3: death: hazard ratio, 1.49; 95% confidence interval, 1.02 to 2.18; P=0.04; ESRD: hazard ratio, 1.72; 95% confidence interval, 1.0 to 2.97; P=0.05; quartile 4: death: hazard ratio, 1.99; 95% confidence interval, 1.34 to 2.93; P<0.001; ESRD: hazard ratio, 3.73; 95% confidence interval, 2.1 to 6.3; P<0.001). The other independent risk factors were (1) preexisting cardiovascular disease, age >65 years old, and eGFR=15-30 ml/min per 1.73 m(2) for death and (2) age ≤65 years old, eGFR<30 ml/min per 1.73 m(2), urinary protein-to-creatinine ratio >30 mg/mmol, and serum phosphate level >4.65 mg/dl for progression to ESRD.ConclusionsAn elevated serum combined Ig free light chain level is an independent risk factor for mortality and progression to ESRD in patients with stages 3-5 CKD managed in secondary care.

Dataset Information

Comparison of 2 Serum-Free Light-Chain Assays in CKD Patients.

Publications

Comparison of 2 Serum-Free Light-Chain Assays in CKD Patients.

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