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Increment of Serum Free Light Chain Kappa/Lambda Ratio in Patients with Renal Dysfunction
Laboratory Medicine Online ; : 12-16, 2019.
Artigo em Coreano | WPRIM | ID: wpr-719667
ABSTRACT

BACKGROUND:

Since free light chain (FLC) is metabolized in the kidney, serum FLC concentration and kappa/lambda ratio are increased in patients with decreased renal function, even in the absence of monoclonal protein. In this study, we measured serum FLC levels to investigate the change in kappa/lambda ratios in relation to the severity of renal dysfunction.

METHODS:

Serum FLC concentrations were measured in 92 archived serum samples from patients diagnosed with chronic kidney disease using the Freelite assay (The Binding Site Group Ltd., UK), and kappa/lambda ratios were calculated. Serum creatinine levels were assayed to calculate estimated glomerular filtration rate (eGFR), and patients were divided into subgroups according to Kidney Disease Improving Global Outcomes (KDIGO) guidelines. We analyzed the difference in serum FLC levels and kappa/lambda ratios between subgroups.

RESULTS:

Serum FLC levels and kappa/lambda ratios increased depending on the severity of renal dysfunction. When patients were classified by setting cut-off value of eGFR as 60 mL/min/1.73 m2 (group A eGFR ≥60 mL/min/1.73 m2, group B < 60 mL/min/1.73 m2), the kappa/lambda ratio of group B was significantly higher than that of group A (group B 1.60±0.46 vs. group A 1.35±0.27, P=0.018). Serum FLC kappa/lambda ratios were within the previously determined renal reference interval (0.37–3.1).

CONCLUSIONS:

When interpreting results of serum FLC kappa/lambda ratio, renal function status should be considered in addition to hematological findings. If renal function deteriorates, a wider renal reference interval is preferred instead of the usual reference interval.
Assuntos

Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Sítios de Ligação / Creatinina / Insuficiência Renal Crônica / Taxa de Filtração Glomerular / Rim / Nefropatias Tipo de estudo: Guia de Prática Clínica Limite: Humanos Idioma: Coreano Revista: Laboratory Medicine Online Ano de publicação: 2019 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Sítios de Ligação / Creatinina / Insuficiência Renal Crônica / Taxa de Filtração Glomerular / Rim / Nefropatias Tipo de estudo: Guia de Prática Clínica Limite: Humanos Idioma: Coreano Revista: Laboratory Medicine Online Ano de publicação: 2019 Tipo de documento: Artigo