The association of serum-free light-chain levels with markers of renal function

Abstract

Background: The kidney is often affected in plasma cell dyscrasias, usually due to the effects of nephrotoxic monoclonal-free light chains. Renal failure due to a monoclonal gammopathy may be detected by the highly sensitive serum-free light-chain (sFLC) ratio yet missed by electrophoretic assays. The aim of this study was to assess sFLC levels in relation to markers of renal function. Methods: Five-hundred thirteen patients were included in this study. sFLC levels were measured by Freelite Õ (The Binding Site Group Ltd, Birmingham, UK) assay using the BNII nephelometer (Siemens Diagnostics, Germany). Kappa/lambda (k/) sFLC ratio was calculated. Serum creatinine levels were analyzed by modified Jaffe method in Cobas 8000 analyser. GFR was estimated by the CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equation. Patients were assigned to two groups depending on their eGFR values: 60 mL/min/1.73 m

Comparison of serum and urine free light chain analysis in clinical diagnosis

“…Therefore, the results of this study are consistent with the fact that a decrease in eGFR is associated with an increase in sFLC levels [10].…”

“…Under healthy conditions, only a small amount of FLC is excreted in the urine because FLC is degraded rapidly by renal tubular reabsorption and rapidly metabolized in the proximal tubule. Therefore, the results of this study are consistent with the fact that a decrease in eGFR is associated with an increase in sFLC levels [ 10 ].…”

C3 glomerulonephritis along with light chain proximal tubulopathy without crystal deposits in multiple myeloma: a case report

“…Drayson and Karatoy Erdem reported a strong correlation between higher levels of serum-free light chains (> 800 mg/dL) and the severity of multiple myeloma renal impairment [8,9]. While varying degrees of renal injury was observed in six patients previously reported, our patient, who had a higher lambda serum-free Fig.…”

C3 Glomerulonephritis Along With Light Chain Tubular Reabsorption in Multiple Myeloma: A Case Report

“…Mark T. Drayson and Bilge Karatoy Erdem found that there was a strong correlation between higher levels of serum free light chains (greater than 800 mg/dl) and the severity of multiple myeloma renal impairment [8,9].There were varying degrees of renal injury in these 6 patients previously reported, but our patient who had a higher level of lamda serum free light chain didn't show a signi cant increase in serum creatinine and 24hUTP. There were two reasons for this situation: First of all, although our patient had a higher level of serum free light chain, the time from onset to diagnosis was too short to result in renal dysfunction.…”