肾功能损害对kappa游离轻链指数的影响。

IF 3.8 2区医学 Q1 MEDICAL LABORATORY TECHNOLOGY

Clinical chemistry and laboratory medicine Pub Date : 2025-04-21 DOI:10.1515/cclm-2025-0007

Martin Schmidauer, Fabian Föttinger, Klaus Berek, Michael Auer, Robert Barket, Franziska Di Pauli, Nik Krajnc, Markus Ponleitner, Anne Zinganell, Tobias Zrzavy, Florian Deisenhammer, Janette Walde, Gabriel Bsteh, Harald Hegen

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引用次数: 0

摘要

目的：探讨肾功能对脑脊液κ-FLC浓度及/或κ-FLC指数的影响。方法：纳入非炎症性神经系统疾病患者。κ-FLC指数计算为（CSF κ-FLC/血清κ-FLC）/白蛋白商。采用结构方程模型（SEM）评价GFR对血清κ-FLC浓度和白蛋白商（Qalb）的直接影响，并通过这两个变量间接影响CSF κ-FLC浓度。结果：共纳入129例患者，中位年龄65岁，42% 为女性。κ-FLC指数为0.57 ~ 3.56，肾小球滤过率（GFR）为17 ~ 128 mL/min/1.73 m2。GFR与CSF κ-FLC浓度呈相关性（r= -0.52, palb (β= -0.17)），而CSF κ-FLC浓度随血清κ-FLC浓度（β=0.75）和Qalb （β=0.39）而升高，表明GFR不直接影响CSF κ-FLC浓度（RMSEA=0.043）。结论：脑脊液κ-FLC浓度与肾功能无直接关系。κ-FLC指数通过考虑血清κ-FLC浓度和Qalb来补偿肾功能的影响。κ-FLC指数可以在不考虑肾功能的情况下解释。

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Impact of renal function impairment on kappa free light chain index.

Objectives: To investigate whether renal function impacts CSF κ-FLC concentration and/or κ-FLC index.

Methods: Patients with non-inflammatory neurological diseases were eligible. κ-FLC index was calculated as (CSF κ-FLC/serum κ-FLC)/albumin quotient. Structural equation modeling (SEM) was used to evaluate the direct influence of GFR on serum κ-FLC concentration and albumin quotient (Q_alb), and via these two variables the indirect influence on CSF κ-FLC concentration.

Results: A total of 129 patients with a median age of 65 years and 42 % females were included. κ-FLC index ranged from 0.57 to 3.56 and glomerular filtration rate (GFR) ranged from 17 to 128 mL/min/1.73 m². While a correlation of GFR with CSF κ-FLC concentration was observed (r= -0.52, p<0.001), there was no statistically significant correlation with κ-FLC index (r=0.14, p=0.113). SEM revealed that higher age was associated with lower GFR (β= -0.53), which led to higher serum κ-FLC concentration (β= -0.45) and higher Q_alb (β= -0.17), while CSF κ-FLC concentration increased with serum κ-FLC concentration (β=0.75) and Q_alb (β=0.39), indicating that GFR did not directly influence CSF κ-FLC concentration (RMSEA=0.043).

Conclusions: CSF κ-FLC concentration is not directly affected by renal function. The κ-FLC index compensates for renal function effects by factoring in serum κ-FLC concentration and Q_alb. κ-FLC index can be interpreted without considering renal function.

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来源期刊

Clinical chemistry and laboratory medicine 医学-医学实验技术

CiteScore

11.30

自引率

16.20%

发文量

306

审稿时长

3 months

期刊介绍： Clinical Chemistry and Laboratory Medicine (CCLM) publishes articles on novel teaching and training methods applicable to laboratory medicine. CCLM welcomes contributions on the progress in fundamental and applied research and cutting-edge clinical laboratory medicine. It is one of the leading journals in the field, with an impact factor over 3. CCLM is issued monthly, and it is published in print and electronically. CCLM is the official journal of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and publishes regularly EFLM recommendations and news. CCLM is the official journal of the National Societies from Austria (ÖGLMKC); Belgium (RBSLM); Germany (DGKL); Hungary (MLDT); Ireland (ACBI); Italy (SIBioC); Portugal (SPML); and Slovenia (SZKK); and it is affiliated to AACB (Australia) and SFBC (France). Topics: - clinical biochemistry - clinical genomics and molecular biology - clinical haematology and coagulation - clinical immunology and autoimmunity - clinical microbiology - drug monitoring and analysis - evaluation of diagnostic biomarkers - disease-oriented topics (cardiovascular disease, cancer diagnostics, diabetes) - new reagents, instrumentation and technologies - new methodologies - reference materials and methods - reference values and decision limits - quality and safety in laboratory medicine - translational laboratory medicine - clinical metrology Follow @cclm_degruyter on Twitter!