Multiple myeloma can be accurately diagnosed in acute kidney injury patients using a rapid serum free light chain test.
BMC Nephrol
; 18(1): 247, 2017 Jul 20.
Article
en En
| MEDLINE
| ID: mdl-28728609
ABSTRACT
BACKGROUND:
Acute kidney injury (AKI) is common in patients with multiple myeloma (MM). Whether serum free light chain (sFLC) measurements can distinguish between myeloma and other causes of AKI requires confirmation to guide early treatment. A rapid and portable sFLC test (Seralite®) is newly available and could reduce delays in obtaining sFLC results and accelerate diagnosis in patients with unexplained AKI. This study evaluated the accuracy of Seralite® to identify MM as the cause of AKI.METHOD:
sFLCs were retrospectively analysed in patients with AKI stage 3 as per KDIGO criteria (i.e. serum creatinine ≥354 µmol/L or those on dialysis treatment) (n = 99); 45/99 patients had a confirmed MM diagnosis.RESULTS:
The Seralite® κλ FLC ratio accurately diagnosed all MM patients in the presence of AKI a range of 0.14-2.02 returned 100% sensitivity and specificity for identifying all non-myeloma related AKI patients. The sFLC difference (dFLC) also demonstrated high sensitivity (91%) and specificity (100%) an optimal cut-off of 399 mg/L distinguished between myeloma and non-myeloma AKI patients. We propose a pathway of patient screening and stratification in unexplained AKI for use of Seralite® in clinical practice, with a κλ ratio range of 0.14-2.02 and dFLC 400 mg/L as decision points.CONCLUSIONS:
Seralite® accurately differentiates between AKI due to MM and AKI due to other causes in patients considered at risk of myeloma. This rapid test can sensitively screen for MM in patients with AKI and help inform early treatment intervention.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Cadenas Ligeras de Inmunoglobulina
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Lesión Renal Aguda
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Mieloma Múltiple
Tipo de estudio:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
BMC Nephrol
Asunto de la revista:
NEFROLOGIA
Año:
2017
Tipo del documento:
Article
País de afiliación:
Reino Unido