The Association between Polyclonal Combined Serum Free Light Chain Concentration and Mortality in Individuals with Early Chronic Kidney Disease

A major component of increased mortality risk in people with chronic kidney disease (CKD) is associated with non-traditional cardiovascular risk factors including markers of inflammation. We studied whether a novel marker of systemic inflammation, elevated serum combined polyclonal immunoglobulin fr...

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Bibliographic Details
Published in:PloS one 2015-07, Vol.10 (7), p.e0129980-e0129980
Main Authors: Assi, Lakhvir K, McIntyre, Natasha, Fraser, Simon, Harris, Scott, Hutchison, Colin A, McIntyre, Chris W, Cockwell, Paul, Taal, Maarten W
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Analysis
Arthritis
Binding sites
Biomarkers
Biomarkers - blood
C-reactive protein
Cardiovascular diseases
Case-Control Studies
Chains
Chronic illnesses
Chronic kidney failure
Confidence intervals
Diabetes
Epidermal growth factor receptors
Female
Hazard assessment
Health aspects
Health risk assessment
Health risks
Hospitals
Humans
Immunoglobulin kappa-Chains - blood
Immunoglobulin lambda-Chains - blood
Immunoglobulins
Inflammation
Kidney diseases
Light
Light chains
Lupus
Lymphoma
Male
Markers
Medicine
Monoclonal gammopathy
Mortality
Obesity
Patients
Population
Primary care
Recruitment
Renal Insufficiency, Chronic - blood
Risk analysis
Risk factors
Studies
Survival
Values
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Summary:A major component of increased mortality risk in people with chronic kidney disease (CKD) is associated with non-traditional cardiovascular risk factors including markers of inflammation. We studied whether a novel marker of systemic inflammation, elevated serum combined polyclonal immunoglobulin free light chains (cFLC), was an independent risk factor for increased all-cause mortality in people with CKD stage 3. In a prospective community based cohort study, 1695 participants with stage 3 CKD and no cases of monoclonal gammopathy had cFLC concentrations measured. cFLC levels were determined using the summation of Freelite kappa and lambda assays. All other bioclinical variables were collected at the time of sample collection. Kaplan-Meier plots and Cox proportional hazards analysis was used to assess the relationship between high cFLC levels (>43.3 mg/L) and mortality. There were 167 deaths (10%) after a median of 1375 days. cFLC levels at recruitment were higher in participants who died compared with those who were alive at the end of the study; median: 46.5 mg/L (IQR: 36.1-65.4 mg/L) and 35.4 mg/L (28.1-46.6 mg/L) respectively, P 43.3 mg/L levels had an increased risk of mortality compared to people with normal cFLC levels (P
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0129980