Comparison of 2 Serum-Free Light-Chain Assays in CKD Patients

Sprangers, Ben; Claes, Kathleen; Evenepoel, Pieter; Kuypers, Dirk; Poesen, Koen; Delforge, Michel; Bossuyt, Xavier; Meijers, Björn

doi:10.1016/j.ekir.2020.01.019

Cited by 19 publications

(14 citation statements)

References 19 publications

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“…It is demonstrated that hemodialysis contributes to serum FLCs ( 30 ). Additionally, the different FLCs detection methods might be responsible for the inconsistent findings of Desjardins L and ours, as FLCs are different by Freelite assay and by N Latex assay ( 31 ). The non-synchronicity of the alterations between microbiome composition and CKD stage and between microbiome composition and FLC κ/λ indicate that the rate of loss in kidney function decline appear to be inconsistent with the alterations of gut microbiome and FLCs.…”

Section: Discussionmentioning

confidence: 82%

Alteration of the Gut Microbiome in Chronic Kidney Disease Patients and Its Association With Serum Free Immunoglobulin Light Chains

Liu

Lin

et al. 2021

Front. Immunol.

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ObjectivesGut dysbiosis is associated with chronic kidney disease (CKD), and serum free immunoglobulin light chains (FLCs) are biomarkers for CKD. This study aims to assess the CKD gut microbiome and to determine its impact on serum FLC levels.MethodsTo control for confounders, 100 patients and sex- and age-matched healthy controls (HCs) were recruited. The gut microbiome was assessed by sequencing 16S rRNA gene V3-V4 hypervariable regions. Phylogenetic Investigation of Communities by Reconstruction of Unobserved States was applied to infer functional metabolic pathways. When observing group differences in the microbiome and predicted metabolic pathways, demographic confounders were adjusted using binary logistic regression; when examining impacts of the gut microbiome and metabolic pathways on serum FLCs, factors influencing FLC levels were adjusted using multiple regression.ResultsPrincipal coordinate analysis revealed a significantly different bacterial community between the CKD and HC groups (P < 0.05). After adjusting for confounders, lower Chao 1, observed species and Shannon indices based on binary logistic regression predicted CKD prevalence. Actinobacteria, Alistipes, Bifidobacterium and Bifidobacterium longum enrichment, upregulation of metabolic pathways of bacterial toxin, chloroalkane and chloroalkene degradation, and Staphylococcus aureus infection also predicted CKD prevalence (P < 0.05). Furthermore, depletion of Actinobacteria and Bifidobacterium and reduced chloroalkane and chloroalkene degradation predicted high levels of FLC λ (P < 0.05).ConclusionsGut dysbiosis in CKD patients was confirmed by controlling for confounders in the present study. Additionally, the association between gut dysbiosis and FLC λ levels demonstrates the existence of crosstalk between the microbiome and immune response in CKD.

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Section: Discussionmentioning

confidence: 82%

Alteration of the Gut Microbiome in Chronic Kidney Disease Patients and Its Association With Serum Free Immunoglobulin Light Chains

Liu

Lin

et al. 2021

Front. Immunol.

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“…It has been confirmed by many researchers that the determination of ratio by the N-Latex method has nothing to do with renal function [ 22 ]. The latest research in 2020 showed that the FLC κ / λ obtained by the Freelite method was negatively correlated with eGFR, while N-Latex was positively correlated, but they were all within the reference range of healthy people [ 23 ]. Our research also confirmed this.…”

Section: Discussionmentioning

confidence: 99%

Using Two Detection Methods to Observe the Changes and Significance of Free Light Chain in Serum and Urine in Patients with Renal Insufficiency

Bán

Sun

et al. 2022

BioMed Research International

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Background. Free light chains κ and λ (FLC κ, FLC λ) are of great significance in diagnostic and monitoring monoclonal gammopathy. Freelite and N-Latex methods are two common monitoring methods at present. But the two meanings are not completely equivalent, especially for patients with renal insufficiency. We analyzed the changes of serum and urine FLC in renal insufficiency patients without monoclonal gammopathy and the clinical significance of these changes. Methods. This study is an observational study. Patients ≥ 18 years old, who met the diagnostic criteria of chronic kidney disease (CKD), excluding monoclonal gammopathy, were selected. Fasting serum and 24-hour urine were taken to detect serum FLC κ, serum FLC λ, SCr, serum β2-microglobulin, urinary FLC κ, urinary FLC λ, urinary α1-microglobulin, and urinary β2-microglobulin. Results. There was a good correlation between the two methods for determining serum/urinary FLC. No matter serum or urine, FLC showed a good correlation with renal function by the N-Latex method, but not by the Freelite method. Under the N-Latex method, FLC κ/λ remained stable, which was basically within the reference range of healthy people and was not affected by renal function. There was a good correlation between FLC detected by N-Latex and microglobulin in serum and urine. Conclusion. When the concentration of FLC is low, the N-Latex method is more recommended to monitor FLC. The FLC measured by the N-Latex method is more closely related to renal function. The ratio of FLC κ/λ determined by the N-Latex method remained stable within the recommended range.

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“…These findings can be encountered in patients with chronic kidney disease (CKD) or with monoclonal gammopathy of undetermined significance (MGUS). In patients with CKD, as the glomerular filtration rate (GFR) declines, the renal clearance of polyclonal FLC decreases and serum concentrations rise 8 . The FLC ratio also varies as the GFR declines, but this depends on the FLC assay available [Freelite assay (Binding Site, Birmingham, UK) or N Latex assay (Siemens, Marburg, Germany)] 8 .…”

Section: Definitions and Classificationsmentioning

confidence: 99%

“…In patients with CKD, as the glomerular filtration rate (GFR) declines, the renal clearance of polyclonal FLC decreases and serum concentrations rise 8 . The FLC ratio also varies as the GFR declines, but this depends on the FLC assay available [Freelite assay (Binding Site, Birmingham, UK) or N Latex assay (Siemens, Marburg, Germany)] 8 . With the N Latex assay, the FLC ratio decreases as GFR declines but no reference range in CKD has yet been proposed.…”

Section: Definitions and Classificationsmentioning

confidence: 99%

“…8 The FLC ratio also varies as the GFR declines, but this depends on the FLC assay available [Freelite assay (Binding Site, Birmingham, UK) or N Latex assay (Siemens, Marburg, Germany)]. 8 With the N Latex assay, the FLC ratio decreases as GFR declines but no reference range in CKD has yet been proposed. By contrast, with the most frequently used Freelite assay, FLC ratio increases as GFR declines and a ratio of 0.37 to 3.…”

Section: Non-invasive Diagnostic Criteriamentioning

confidence: 99%

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Diagnosis and treatment of cardiac amyloidosis. A position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases

García‐Pavía

Rapezzi

Adler

et al. 2021

European J of Heart Fail

227

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Cardiac amyloidosis is a serious and progressive infiltrative disease that is caused by the deposition of amyloid fibrils at the cardiac level. It can be due to rare genetic variants in the hereditary forms or as a consequence of acquired conditions. Thanks to advances in imaging techniques and the possibility of achieving a non‐invasive diagnosis, we now know that cardiac amyloidosis is a more frequent disease than traditionally considered. In this position paper the Working Group on Myocardial and Pericardial Disease proposes an invasive and non‐invasive definition of cardiac amyloidosis, addresses clinical scenarios and situations to suspect the condition and proposes a diagnostic algorithm to aid diagnosis. Furthermore, we also review how to monitor and treat cardiac amyloidosis, in an attempt to bridge the gap between the latest advances in the field and clinical practice.

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Comparison of 2 Serum-Free Light-Chain Assays in CKD Patients

Cited by 19 publications

References 19 publications

Alteration of the Gut Microbiome in Chronic Kidney Disease Patients and Its Association With Serum Free Immunoglobulin Light Chains

Alteration of the Gut Microbiome in Chronic Kidney Disease Patients and Its Association With Serum Free Immunoglobulin Light Chains

Using Two Detection Methods to Observe the Changes and Significance of Free Light Chain in Serum and Urine in Patients with Renal Insufficiency

Diagnosis and treatment of cardiac amyloidosis. A position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases

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