NUK - logo
E-viri
Celotno besedilo
Recenzirano Odprti dostop
  • Defining new reference inte...
    Long, Thorir Einarsson; Indridason, Olafur Skuli; Palsson, Runolfur; Rognvaldsson, Sæmundur; Love, Thorvardur Jon; Thorsteinsdottir, Sigrun; Sverrisdottir, Ingigerdur Solveig; Vidarsson, Brynjar; Onundarson, Pall Torfi; Agnarsson, Bjarni Agnar; Sigurdardottir, Margret; Thorsteinsdottir, Ingunn; Olafsson, Isleifur; Thordardottir, Asdis Rosa; Eythorsson, Elias; Jonsson, Asbjorn; Gislason, Gauti; Olafsson, Andri; Steingrimsdottir, Hlif; Hultcrantz, Malin; Durie, Brian G. M.; Harding, Stephen; Landgren, Ola; Kristinsson, Sigurdur Yngvi

    Blood cancer journal (New York), 09/2022, Letnik: 12, Številka: 9
    Journal Article

    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 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.