Defining new reference intervals for serum free light chains in individuals with chronic kidney disease: Results of the iStopMM study.

Autor: Long TE; University of Iceland, Reykjavik, Iceland.; Skane University Hospital, Lund, Sweden.; Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland., Indridason OS; Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland., Palsson R; University of Iceland, Reykjavik, Iceland.; Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland., Rognvaldsson S; University of Iceland, Reykjavik, Iceland.; Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland., Love TJ; University of Iceland, Reykjavik, Iceland.; Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland., Thorsteinsdottir S; University of Iceland, Reykjavik, Iceland.; Department of Hematology, Rigshospitalet, Copenhagen, Denmark., Sverrisdottir IS; University of Iceland, Reykjavik, Iceland.; Sahlgrenska University Hospital, Gothenburg, Sweden., Vidarsson B; Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland., Onundarson PT; University of Iceland, Reykjavik, Iceland.; Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland., Agnarsson BA; University of Iceland, Reykjavik, Iceland.; Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland., Sigurdardottir M; Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland., Thorsteinsdottir I; Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland., Olafsson I; Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland., Thordardottir AR; University of Iceland, Reykjavik, Iceland., Eythorsson E; Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland., Jonsson A; University of Iceland, Reykjavik, Iceland.; Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland., Gislason G; University of Iceland, Reykjavik, Iceland., Olafsson A; University of Iceland, Reykjavik, Iceland., Steingrimsdottir H; Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland., Hultcrantz M; Myeloma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Durie BGM; Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Outpatient Cancer Center, Los Angeles, CA, USA., Harding S; Binding Site Group Ltd, Birmingham, UK., Landgren O; Myeloma Program, Department of Medicine, University of Miami, Sylvester Comprehensive Cancer Center, Miami, USA., Kristinsson SY; University of Iceland, Reykjavik, Iceland. sigyngvi@hi.is.; Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland. sigyngvi@hi.is.
Jazyk: angličtina
Zdroj: Blood cancer journal [Blood Cancer J] 2022 Sep 14; Vol. 12 (9), pp. 133. Date of Electronic Publication: 2022 Sep 14.
DOI: 10.1038/s41408-022-00732-3
Abstrakt: Serum free light chain (FLC) concentration is greatly affected by kidney function. Using a large prospective population-based cohort, we aimed to establish a reference interval for FLCs in persons with chronic kidney disease (CKD). A total of 75422 participants of the iStopMM study were screened with serum FLC, serum protein electrophoresis and immunofixation. Estimated glomerular filtration rate (eGFR) was calculated from serum creatinine. Central 99% reference intervals were determined, and 95% confidence intervals calculated. Included were 6461 (12%) participants with measured FLCs, eGFR < 60 mL/min/1.73 m 2 , not receiving renal replacement therapy, and without evidence of monoclonality. Using current reference intervals, 60% and 21% had kappa and lambda FLC values outside the normal range. The FLC ratio was outside standard reference interval (0.26-1.65) in 9% of participants and outside current kidney reference interval (0.37-3.10) in 0.7%. New reference intervals for FLC and FLC ratio were established. New reference intervals for the FLC ratio were 0.46-2.62, 0.48-3.38, and 0.54-3.30 for eGFR 45-59, 30-44, and < 30 mL/min/1.73 m 2 groups, respectively. The crude prevalence of LC-MGUS in CKD patients was 0.5%. We conclude that current reference intervals for FLC and FLC ratio are inaccurate in CKD patients and propose new eGFR based reference intervals to be implemented.
(© 2022. The Author(s).)
Databáze: MEDLINE
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