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Glomerular filtration rate as a determinant of free light chains in renal transplantation.
MedLine Citation:
PMID:  24028899     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Transplant patients have an increase incidence of lymphoproliferative disorders. The development of sensitive immunoassay for serum free light chains (FLC) determination has improved the diagnosis of monoclonal gammapathy. However, metabolism of FLC largely depends on renal function which could lead to misinterpretation of results. The aim of this study was to assess polyclonal FLC in kidney transplant recipients in relation to markers of renal function.
MATERIALS AND METHODS: 97 renal transplant patients (median transplantation follow-up of 2.2years) were included in this study. Kappa FLC, Lambda FLC and cystatin C were measured by particle-enhanced turbidimetric immunoassay (PETIA) using kits from Binding Site (Birmingham, UK) on SPAPLUS® analyzer. Glomerular filtration rate was measured using urinary clearance of 99mTc-DTPA and estimated using CKD-EPI creatinine 2009, CKD-EPI cystatin C 2012 and CKD-EPI creatinine-cystatin C 2012.
RESULTS: Sera kappa FLC was 22.38 [6.39 - 68.91] mg/L and sera lambda FLC was 15.66 [7.29 - 50.81] mg/L. Both levels of Kappa and Lambda were correlated with renal function. Median K / L ratio was 1.34 [0.57 to 2.67] leaving 19.6% of renal transplant patients outside the normal reference range ([0.26-1.65]). However, using a reference interval normalized by renal function ([0.37-3.1]), none of our patients was classified as abnormal.
CONCLUSION: K / L ratio should be cautiously analyzed in renal transplantation and renal function, estimated by creatinine/cystatin C equations should be taken into account.
Authors:
Anne-Sophie Bargnoux; Noémie Simon; Valérie Garrigue; Anne-Marie Dupuy; Stéphanie Badiou; Georges Mourad; Jean-Paul Cristol
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-9-9
Journal Detail:
Title:  Clinical biochemistry     Volume:  -     ISSN:  1873-2933     ISO Abbreviation:  Clin. Biochem.     Publication Date:  2013 Sep 
Date Detail:
Created Date:  2013-9-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0133660     Medline TA:  Clin Biochem     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013.
Affiliation:
Laboratoire de Biochimie, CHRU Montpellier, Univ Montpellier 1, Montpellier, F-34000 France.
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