PMID- 23024162
OWN - NLM
STAT- MEDLINE
DCOM- 20130513
LR  - 20211021
IS  - 1555-905X (Electronic)
IS  - 1555-9041 (Print)
IS  - 1555-9041 (Linking)
VI  - 7
IP  - 12
DP  - 2012 Dec
TI  - Urinary albumin excretion patterns of patients with cast nephropathy and other 
      monoclonal gammopathy-related kidney diseases.
PG  - 1964-8
LID - 10.2215/CJN.11161111 [doi]
AB  - BACKGROUND AND OBJECTIVES: Multiple myeloma is responsible for a wide variety of 
      renal pathologies. Urinary protein and monoclonal spike cannot be used to 
      diagnose cast nephropathy (CN). Because albuminuria is a hallmark of glomerular 
      disease, this study evaluated the percentage of urinary albumin excretion (%UAE) 
      as a tool to differentiate CN from Ig light chain amyloidosis (AL), light chain 
      deposition disease (LCDD), and acute tubular necrosis (ATN). DESIGN, SETTING, 
      PARTICIPANTS, & MEASUREMENTS: Patients were selected from the Renal Biopsy 
      Database and the Dysproteinemia Database. Participants were excluded if 
      laboratory data were missing within 1 week of the renal biopsy. The %UAE was 
      obtained from urine protein electrophoresis. RESULTS: From 1992 to 2011, 260 
      patients were biopsied (177 with AL, 28 with LCDD, 43 with CN, and 12 with ATN). 
      The %UAE for CN patients was significantly lower (7%) than for ATN (25%), LCDD 
      (55%), and AL (70%) patients (P<0.001). Significant differences were also found 
      in serum creatinine, serum albumin, free light chain ratio, total urine protein, 
      and urine monoclonal spike; only the %UAE remained independently associated with 
      CN in a logistic regression model (P<0.001). The area under the curve for the 
      receiver operator characteristic curve for %UAE was 0.99. At <25%, the %UAE had a 
      sensitivity of 0.98, specificity of 0.94, positive predictive value of 0.75, and 
      negative predictive value of 0.99. CONCLUSIONS: This study showed that %UAE was 
      significantly less in CN than the other three renal lesions and %UAE may thus be 
      helpful in diagnosis of CN.
FAU - Leung, Nelson
AU  - Leung N
AD  - Division of Hematology, Mayo Clinic, Rochester, Minnesota 55901, USA. 
      leung.nelson@mayo.edu
FAU - Gertz, Morie
AU  - Gertz M
FAU - Kyle, Robert A
AU  - Kyle RA
FAU - Fervenza, Fernando C
AU  - Fervenza FC
FAU - Irazabal, Maria V
AU  - Irazabal MV
FAU - Eirin, Alfonso
AU  - Eirin A
FAU - Kumar, Shaji
AU  - Kumar S
FAU - Cha, Stephen S
AU  - Cha SS
FAU - Rajkumar, S Vincent
AU  - Rajkumar SV
FAU - Lacy, Martha Q
AU  - Lacy MQ
FAU - Zeldenrust, Steve R
AU  - Zeldenrust SR
FAU - Buadi, Francis K
AU  - Buadi FK
FAU - Hayman, Suzanne R
AU  - Hayman SR
FAU - Nasr, Samih H
AU  - Nasr SH
FAU - Sethi, Sanjeev
AU  - Sethi S
FAU - Ramirez-Alvarado, Marina
AU  - Ramirez-Alvarado M
FAU - Witzig, Thomas E
AU  - Witzig TE
FAU - Herrmann, Sandra M
AU  - Herrmann SM
FAU - Dispenzieri, Angela
AU  - Dispenzieri A
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120927
PL  - United States
TA  - Clin J Am Soc Nephrol
JT  - Clinical journal of the American Society of Nephrology : CJASN
JID - 101271570
RN  - 0 (Immunoglobulin Light Chains)
RN  - 0 (Serum Albumin)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Albuminuria/blood/*urine
MH  - Amyloidosis/blood/diagnosis/*urine
MH  - Analysis of Variance
MH  - Area Under Curve
MH  - Chi-Square Distribution
MH  - Creatinine/blood
MH  - Female
MH  - Humans
MH  - Immunoglobulin Light Chains/blood/urine
MH  - Kidney Tubular Necrosis, Acute/blood/diagnosis/*urine
MH  - Male
MH  - Middle Aged
MH  - Multiple Myeloma/blood/*diagnosis/*urine
MH  - Predictive Value of Tests
MH  - ROC Curve
MH  - Serum Albumin/metabolism
MH  - Statistics, Nonparametric
PMC - PMC3513751
EDAT- 2012/10/02 06:00
MHDA- 2013/05/15 06:00
PMCR- 2013/12/07
CRDT- 2012/10/02 06:00
PHST- 2012/10/02 06:00 [entrez]
PHST- 2012/10/02 06:00 [pubmed]
PHST- 2013/05/15 06:00 [medline]
PHST- 2013/12/07 00:00 [pmc-release]
AID - CJN.11161111 [pii]
AID - 11161111 [pii]
AID - 10.2215/CJN.11161111 [doi]
PST - ppublish
SO  - Clin J Am Soc Nephrol. 2012 Dec;7(12):1964-8. doi: 10.2215/CJN.11161111. Epub 
      2012 Sep 27.