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The Influence of Renal Function Impairment on Kappa Free Light Chains in Cerebrospinal Fluid

BACKGROUND: The determination of kappa free light chains (KFLC) in cerebrospinal fluid (CSF) is an upcoming biomarker for the detection of an intrathecal immunoglobulin synthesis. Since renal function impairment leads to altered serum KFLC and albumin concentrations, interpretation of KFLC in CSF ma...

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Autores principales: Konen, Franz F, Schwenkenbecher, Philipp, Wurster, Ulrich, Jendretzky, Konstantin F, Möhn, Nora, Gingele, Stefan, Sühs, Kurt-Wolfram, Hannich, Malte J, Grothe, Matthias, Witte, Torsten, Stangel, Martin, Süße, Marie, Skripuletz, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8619759/
https://www.ncbi.nlm.nih.gov/pubmed/34840504
http://dx.doi.org/10.1177/11795735211042166
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author Konen, Franz F
Schwenkenbecher, Philipp
Wurster, Ulrich
Jendretzky, Konstantin F
Möhn, Nora
Gingele, Stefan
Sühs, Kurt-Wolfram
Hannich, Malte J
Grothe, Matthias
Witte, Torsten
Stangel, Martin
Süße, Marie
Skripuletz, Thomas
author_facet Konen, Franz F
Schwenkenbecher, Philipp
Wurster, Ulrich
Jendretzky, Konstantin F
Möhn, Nora
Gingele, Stefan
Sühs, Kurt-Wolfram
Hannich, Malte J
Grothe, Matthias
Witte, Torsten
Stangel, Martin
Süße, Marie
Skripuletz, Thomas
author_sort Konen, Franz F
collection PubMed
description BACKGROUND: The determination of kappa free light chains (KFLC) in cerebrospinal fluid (CSF) is an upcoming biomarker for the detection of an intrathecal immunoglobulin synthesis. Since renal function impairment leads to altered serum KFLC and albumin concentrations, interpretation of KFLC in CSF may be influenced by these parameters. METHODS: In this two-center study, the influence of renal function (according to the CKD-EPI creatinine equation) on KFLC and albumin concentrations was investigated in patients with “physiological” (n = 139), “non-inflammatory” (n = 146), and “inflammatory” (n = 172) CSF profiles in respect to the KFLC index and the evaluation in quotient diagrams in reference to the hyperbolic reference range (KFLC IF). RESULTS: All sample groups displayed declining KFLC indices and KFLC IF values with decreasing renal function (P-values between <.0001 and .0209). In “inflammatory” CSF profile samples, 15% of the patients presented a KFLC index <5.9 while 10% showed an intrathecal KFLC fraction below Q(Kappa)(lim), suggesting possible false negative KFLC results. CONCLUSIONS: The influence of renal function should be considered while interpreting KFLC results in patients with neuroinflammatory diseases. The interpretation of KFLC in quotient diagrams is less susceptible to renal function impairment than the KFLC index and should be preferentially used.
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spelling pubmed-86197592021-11-27 The Influence of Renal Function Impairment on Kappa Free Light Chains in Cerebrospinal Fluid Konen, Franz F Schwenkenbecher, Philipp Wurster, Ulrich Jendretzky, Konstantin F Möhn, Nora Gingele, Stefan Sühs, Kurt-Wolfram Hannich, Malte J Grothe, Matthias Witte, Torsten Stangel, Martin Süße, Marie Skripuletz, Thomas J Cent Nerv Syst Dis Review Article BACKGROUND: The determination of kappa free light chains (KFLC) in cerebrospinal fluid (CSF) is an upcoming biomarker for the detection of an intrathecal immunoglobulin synthesis. Since renal function impairment leads to altered serum KFLC and albumin concentrations, interpretation of KFLC in CSF may be influenced by these parameters. METHODS: In this two-center study, the influence of renal function (according to the CKD-EPI creatinine equation) on KFLC and albumin concentrations was investigated in patients with “physiological” (n = 139), “non-inflammatory” (n = 146), and “inflammatory” (n = 172) CSF profiles in respect to the KFLC index and the evaluation in quotient diagrams in reference to the hyperbolic reference range (KFLC IF). RESULTS: All sample groups displayed declining KFLC indices and KFLC IF values with decreasing renal function (P-values between <.0001 and .0209). In “inflammatory” CSF profile samples, 15% of the patients presented a KFLC index <5.9 while 10% showed an intrathecal KFLC fraction below Q(Kappa)(lim), suggesting possible false negative KFLC results. CONCLUSIONS: The influence of renal function should be considered while interpreting KFLC results in patients with neuroinflammatory diseases. The interpretation of KFLC in quotient diagrams is less susceptible to renal function impairment than the KFLC index and should be preferentially used. SAGE Publications 2021-11-19 /pmc/articles/PMC8619759/ /pubmed/34840504 http://dx.doi.org/10.1177/11795735211042166 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review Article
Konen, Franz F
Schwenkenbecher, Philipp
Wurster, Ulrich
Jendretzky, Konstantin F
Möhn, Nora
Gingele, Stefan
Sühs, Kurt-Wolfram
Hannich, Malte J
Grothe, Matthias
Witte, Torsten
Stangel, Martin
Süße, Marie
Skripuletz, Thomas
The Influence of Renal Function Impairment on Kappa Free Light Chains in Cerebrospinal Fluid
title The Influence of Renal Function Impairment on Kappa Free Light Chains in Cerebrospinal Fluid
title_full The Influence of Renal Function Impairment on Kappa Free Light Chains in Cerebrospinal Fluid
title_fullStr The Influence of Renal Function Impairment on Kappa Free Light Chains in Cerebrospinal Fluid
title_full_unstemmed The Influence of Renal Function Impairment on Kappa Free Light Chains in Cerebrospinal Fluid
title_short The Influence of Renal Function Impairment on Kappa Free Light Chains in Cerebrospinal Fluid
title_sort influence of renal function impairment on kappa free light chains in cerebrospinal fluid
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8619759/
https://www.ncbi.nlm.nih.gov/pubmed/34840504
http://dx.doi.org/10.1177/11795735211042166
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