| Title |
Serum free light chain measurement aids the diagnosis of myeloma in patients with severe renal failure
|
|---|---|
| Published in |
BMC Nephrology, September 2008
|
| DOI | 10.1186/1471-2369-9-11 |
| Pubmed ID | |
| Authors |
Colin A Hutchison, Tim Plant, Mark Drayson, Paul Cockwell, Melpomeni Kountouri, Kolitha Basnayake, Stephen Harding, Arthur R Bradwell, Graham Mead |
| Abstract |
Monoclonal free light chains (FLCs) frequently cause rapidly progressive renal failure in patients with multiple myeloma. Immunoassays which provide quantitative measurement of FLCs in serum, have now been adopted into screening algorithms for multiple myeloma and other lymphoproliferative disorders. The assays indicate monoclonal FLC production by the presence of an abnormal kappa to lambda FLC ratio (reference range 0.26-1.65). Previous work, however, has demonstrated that in patients with renal failure the FLC ratio can be increased above normal with no other evidence of monoclonal proteins suggesting that in this population the range should be extended (reference range 0.37-3.1). This study evaluated the diagnostic sensitivity and specificity of the immunoassays in patients with severe renal failure. Sera from 142 patients with new dialysis-dependent renal failure were assessed by serum protein electrophoresis (SPE), FLC immunoassays and immunofixation electrophoresis. The sensitivity and specificity of the FLC ratio's published reference range was compared with the modified renal reference range for identifying patients with multiple myeloma; by receiver operating characteristic curve analysis. Forty one patients had a clinical diagnosis of multiple myeloma; all of these patients had abnormal serum FLC ratios. The modified FLC ratio range increased the specificity of the assays (from 93% to 99%), with no loss of sensitivity. Monoclonal FLCs were identified in the urine from 23 of 24 patients assessed. Measurement of serum FLC concentrations and calculation of the serum kappa/lambda ratio is a convenient, sensitive and specific method for identifying monoclonal FLC production in patients with multiple myeloma and acute renal failure. Rapid diagnosis in these patients will allow early initiation of disease specific treatment, such as chemotherapy plus or minus therapies for direct removal of FLCs. |
X Demographics
The data shown below were collected from the profiles of 5 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Canada | 2 | 40% |
| Argentina | 1 | 20% |
| Germany | 1 | 20% |
| Unknown | 1 | 20% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 3 | 60% |
| Practitioners (doctors, other healthcare professionals) | 2 | 40% |
Mendeley readers
The data shown below were compiled from readership statistics for 102 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Colombia | 1 | <1% |
| Morocco | 1 | <1% |
| Brazil | 1 | <1% |
| United Kingdom | 1 | <1% |
| Japan | 1 | <1% |
| United States | 1 | <1% |
| Unknown | 96 | 94% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Ph. D. Student | 18 | 18% |
| Researcher | 13 | 13% |
| Other | 12 | 12% |
| Student > Postgraduate | 11 | 11% |
| Student > Doctoral Student | 10 | 10% |
| Other | 20 | 20% |
| Unknown | 18 | 18% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 53 | 52% |
| Biochemistry, Genetics and Molecular Biology | 8 | 8% |
| Agricultural and Biological Sciences | 7 | 7% |
| Immunology and Microbiology | 4 | 4% |
| Nursing and Health Professions | 3 | 3% |
| Other | 11 | 11% |
| Unknown | 16 | 16% |
Attention Score in Context
This research output has an Altmetric Attention Score of 9. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 28 October 2021.
All research outputs
#3,302,497
of 22,965,074 outputs
Outputs from BMC Nephrology
#348
of 2,492 outputs
Outputs of similar age
#10,375
of 88,048 outputs
Outputs of similar age from BMC Nephrology
#1
of 1 outputs
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So far Altmetric has tracked 2,492 research outputs from this source. They receive a mean Attention Score of 4.8. This one has done well, scoring higher than 85% of its peers.
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