Combined analysis using extended renal reference range of serum free light chain ratio and serum protein electrophoresis improves the diagnostic accuracy of multiple myeloma in renal insufficiency.

OBJECTIVES:To determine the diagnostic accuracy of serum free light chain κ/λ ratio (rFLC) using extended renal reference (renal range rFLC) in multiple myeloma (MM) with renal insufficiency. DESIGN AND METHODS:Patients who visited a nephrologist due to renal insufficiency (n=471) were enrolled. Serum FLC quantification, protein electrophoresis (PEP), and pathologic diagnosis were performed. RESULTS:Renal range rFLC showed the highest sensitivity to differentiate MM from non-MM among four tests (conventional rFLC, s-PEP, u-PEP). In intact immoglobulin MM (IIMM), the sensitivity and specificity were lower for both rFLCs than for s-PEP. On the other hand, both rFLC showed higher sensitivity compared than PEPs in light chain MM (LCMM). Combined analysis (renal rFLC+s-PEP) increased the sensitivity for both IIMM and LCMM. CONCLUSIONS:Renal rFLC is a valuable screening tool in renal insufficiency patients suspected of having MM, especially for LCMM. Combined analysis (renal rFLC+s-PEP) improves the diagnostic accuracy for detecting MM in the setting of renal impairment.

KEYWORDS: {{ getKeywords(articleDetailText.words) }}