Defining new reference intervals for serum free light chains in individuals with chronic kidney disease : Results of the iStopMM study
(2022) In Blood Cancer Journal 12(9). p.1-8- Abstract
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 m2, not receiving renal replacement therapy, and without evidence of monoclonality. Using current reference intervals, 60% and... (More)
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 m2, 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 m2 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.
(Less)
- author
- publishing date
- 2022-09-14
- type
- Contribution to journal
- publication status
- published
- keywords
- Humans, Immunoglobulin Light Chains, Immunoglobulin lambda-Chains, Prospective Studies, Reference Values, Renal Insufficiency, Chronic/diagnosis
- in
- Blood Cancer Journal
- volume
- 12
- issue
- 9
- article number
- 133
- pages
- 1 - 8
- publisher
- Nature Publishing Group
- external identifiers
-
- scopus:85137808095
- pmid:36100605
- ISSN
- 2044-5385
- DOI
- 10.1038/s41408-022-00732-3
- language
- English
- LU publication?
- no
- additional info
- © 2022. The Author(s).
- id
- 3b690ccd-0103-4edc-9fcf-e3e787ffb14a
- date added to LUP
- 2024-12-05 16:08:22
- date last changed
- 2025-07-18 22:39:13
@article{3b690ccd-0103-4edc-9fcf-e3e787ffb14a,
abstract = {{<p>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 m2, 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 m2 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.</p>}},
author = {{Long, Thorir Einarsson and Indridason, Olafur Skuli and Palsson, Runolfur and Rognvaldsson, Sæmundur and Love, Thorvardur Jon and Thorsteinsdottir, Sigrun and Sverrisdottir, Ingigerdur Solveig and Vidarsson, Brynjar and Onundarson, Pall Torfi and Agnarsson, Bjarni Agnar and Sigurdardottir, Margret and Thorsteinsdottir, Ingunn and Olafsson, Isleifur and Thordardottir, Asdis Rosa and Eythorsson, Elias and Jonsson, Asbjorn and Gislason, Gauti and Olafsson, Andri and Steingrimsdottir, Hlif and Hultcrantz, Malin and Durie, Brian G M and Harding, Stephen and Landgren, Ola and Kristinsson, Sigurdur Yngvi}},
issn = {{2044-5385}},
keywords = {{Humans; Immunoglobulin Light Chains; Immunoglobulin lambda-Chains; Prospective Studies; Reference Values; Renal Insufficiency, Chronic/diagnosis}},
language = {{eng}},
month = {{09}},
number = {{9}},
pages = {{1--8}},
publisher = {{Nature Publishing Group}},
series = {{Blood Cancer Journal}},
title = {{Defining new reference intervals for serum free light chains in individuals with chronic kidney disease : Results of the iStopMM study}},
url = {{http://dx.doi.org/10.1038/s41408-022-00732-3}},
doi = {{10.1038/s41408-022-00732-3}},
volume = {{12}},
year = {{2022}},
}