Cadena ligera libre kappa como predictor de daño tubular en primera orina de la mañana.
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| Title: | Cadena ligera libre kappa como predictor de daño tubular en primera orina de la mañana. |
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| Alternate Title: | Kappa free light chain as a predictor of tubular damage in first morning urine. |
| Authors: | Parejo Martín, Alfonso1, Carande del Río, María T.1, Robles, Nicolas R.2, Gómez Vera, Sergio1, Fernández Cavada, María Jesús3, Xavier Aller, Cristina1, Sacristán Enciso, Beatriz3, López Gómez, Juan1 lopezhospi@gmail.com |
| Source: | Nefrologia. Jun/Jul2026, Vol. 46 Issue 6, p1-7. 7p. |
| Subjects: | KIDNEY tubules, IMMUNOGLOBULIN light chains, MICROGLOBULINS, BIOMARKERS, KIDNEY diseases, CREATININE, URINATION, KIDNEY injuries |
| Abstract (English): | Introduction: Urine alpha-1-microglobulin protein is a sensitive biomarker for detecting damage in the proximal renal tubules. Free kappa light chains may also be elevated in tubular damage of any origin. The aim of this study was to evaluate whether the detection of free kappa light chains in urine could show earlier tubular damage than alpha-1-microglobulin. Patients and methods: A total of 330 analyses performed between 2020 and 2024 were selected, corresponding to patients who had an estimated glomerular filtration rate between 8-131 mL/min/1.73 m² . Those samples that were normal in first morning urine were selected and the alpha-1-microglobulin adjusted for creatinine was calculated. Taking into account the total population, 2 groups were formed: group with normal alpha-1- microglobulin adjusted for creatinine in first morning urine –NA1MG– and group with elevated alpha-1- microglobulin adjusted for creatinine in first morning urine –EA1MG–. Results: The third quartile of kappa free light chain/creatinine in NA1MG was 15.32 (mg/L)/creatinine (g/L), and 39 samples had a higher value. All of them was within the interquartile range of the kappa free light chain/ creatinine value of the EA1MG group (17-98.04 [mg/L]/creatinine [g/L]). In turn, 36 samples from the EA1MG group had a kappa free light chain/creatinine value < 15.32 (mg/L)/creatinine (g/L), and the remaining 126 urine samples from this group had elevated levels of both parameters, alpha-1-microglobulin and kappa free light chains. Conclusions: Free kappa light chain/creatinine ratio (mg/L)/(g/L) > 15.32 in first morning urine shows tubular damage even with normal alpha-1-microglobulin/creatinine values (< 7.08 alpha-1-microglobulin [mg/L]/creatinine [g/L]). Most patients with these values had a disease with high risk of kidney involvement (diabetes mellitus and/or high blood pressure). Tubular damage would begin with isolated elevation of alpha1-microglobulin or kappa light chains, with earlier elevation of the latter observed in younger patients. Both are more elevated when tubular damage is more severe. [ABSTRACT FROM AUTHOR] |
| Abstract (Spanish): | Introduccion: ́ La proteína alfa-1-microglobulina en orina es un biomarcador sensible para detectar daño en los túbulos renales proximales. Las cadenas ligeras libres kappa tambień pueden estar elevadas en casos de daño tubular de cualquier origen. El objetivo de este estudio fue evaluar si la deteccioń de cadenas ligeras libres kappa en orina podría evidenciar un daño tubular más temprano que la alfa-1-microglobulina. Pacientes y metodos: ́ Se seleccionaron 330 análisis realizados entre 2020 y 2024, correspondientes a pacientes con una tasa de filtrado glomerular estimada entre 8 y 131 mL/min/1,73 m² . Se seleccionaron las muestras normales en la primera orina de la mañana y se calculóla alfa-1-microglobulina corregida por creatinina. Considerando la poblacioń total, se formaron 2 grupos: grupo de orina de primera hora de la mañana con alfa1-microglobulina normal –GA1MN– y grupo de orina de primera hora de la mañana con alfa-1-microglobulina elevada –GA1ME–. Resultados: El tercer cuartil de cadenas ligeras libres kappa/creatinina en la primera orina de la mañana dentro del GA1MN fue de 15,32 (mg/L)/creatinina (g/L), y 39 muestras presentaron un valor superior, encontrándose dentro del rango intercuartílico del valor de cadenas ligeras libres kappa/creatinina del grupo GA1ME (17-98,04 [mg/L]/creatinina [g/L]), estando diagnosticadas en la mayoría de las enfermedades que producen daño tubular. A su vez, 36 muestras del grupo GA1ME presentaron un valor de cadenas ligeras libres kappa/creatinina <15,32 (mg/L)/creatinina (g/L), y las 126 orinas restantes de este grupo tenían elevados ambos parámetros, alfa-1-microglobulina y cadenas ligeras libres kappa. Conclusiones: Un cociente de cadenas ligeras libres kappa (mg/L)/creatinina(g/L) > 15,32 aislado en la primera orina de la mañana evidencia daño tubular incluso con valores normales de alfa-1-microglobulina/ creatinina (< 7,08 alfa 1-microglobulina [mg/L]/creatinina [g/L]). El daño tubular comenzaría por la elevacioń aislada de alfa-1-microglobulina o cadenas ligeras libres kappa de forma aislada, observándose una elevacioń más temprana de estas últimas en pacientes más jovenes. ́ Ambas están más elevadas cuando el daño tubular es más intenso. [ABSTRACT FROM AUTHOR] |
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| Database: | MedicLatina |
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