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Fenton, Anthony, Jesky, Mark D, Webster, Rachel, Stringer, Stephanie J, Yadav, Punit, Chapple, Iain, Dasgupta, Indranil, Harding, Stephen J, Ferro, Charles J and Cockwell, Paul (2018) Association between urinary free light chains and progression to end stage renal disease in chronic kidney disease. PloS one, 13 (5). e0197043. ISSN 1932-6203. This article is available to all HEFT staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their HEFT Athens login IDs
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Association between urinary free light chains and progression to end stage renal disease in chronic kidney disease.pdf - Published Version Available under License Creative Commons Attribution. Download (3MB) | Preview |
Abstract
BACKGROUND
Patients with chronic kidney disease (CKD) are at an increased risk of developing end-stage renal disease (ESRD). We assessed for the first time whether urinary free light chains (FLC) are independently associated with risk of ESRD in patients with CKD, and whether they offer incremental value in risk stratification.
MATERIALS AND METHODS
We measured urinary FLCs in 556 patients with CKD from a prospective cohort study. The association between urinary kappa/creatinine (KCR) and lambda/creatinine (LCR) ratios and development of ESRD was assessed by competing-risks regression (to account for the competing risk of death). The change in C-statistic and integrated discrimination improvement were used to assess the incremental value of adding KCR or LCR to the Kidney Failure Risk Equation (KFRE).
RESULTS
136 participants developed ESRD during a median follow-up time of 51 months. Significant associations between KCR and LCR and risk of ESRD became non-significant after adjustment for estimated glomerular filtration rate (eGFR) and albumin/creatinine ratio (ACR), although having a KCR or LCR >75th centile remained independently associated with risk of ESRD. Neither KCR nor LCR as continuous or categorical variables provided incremental value when added to the KFRE for estimating risk of ESRD at two years.
CONCLUSIONS
Urinary FLCs have an association with progression to ESRD in patients with CKD which appears to be explained to a degree by their correlation with eGFR and ACR. Levels above the 75th centile do have an independent association with ESRD, but do not improve upon a current model for risk stratification.
| Item Type: | Article |
|---|---|
| Additional Information: | This article is available to all HEFT staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their HEFT Athens login IDs |
| Subjects: | WJ Urogenital system. Urology |
| Divisions: | Emergency Services > Renal |
| Related URLs: | |
| Depositing User: | Mrs Semanti Chakraborty |
| Date Deposited: | 18 May 2018 12:35 |
| Last Modified: | 18 May 2018 12:35 |
| URI: | http://www.repository.uhblibrary.co.uk/id/eprint/1656 |
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