Evaluation of nephrologic "risk" in a newly diagnosed case of plasma cell dyscrasias from personal material (1994-2000)
Zelichowski, G.; Raczka, A.; Sułek, K.; Wańkowicz, Z.
Polski merkuriusz lekarski organ Polskiego Towarzystwa Lekarskiego 9(54): 830-833
2000
ISSN/ISBN: 1426-9686 PMID: 11255649 Document Number: 518218
Among 149 patients with recently recognized plasma cell dyscrasia (PCD) in years 1994-2000 72 persons with serologically and nephrologically documented diagnostic profile were selected. In this group of pts we assessed dependence between degree of reduced glomerular filtration rate (GFR), evaluated by serum creatinine concentration and calculated with Barasckay's formula and hypercalcemia, hyperuricemia as well as type of monoclonal protein in urine. We revealed statistically significant higher values of calcium (p = 0.005), uric acid (p = 0.000001) concentrations and higher occurrence of Bence-Jones proteinuria (mainly kappa) in 22 patients with serum creatinine > 1.5 mg/dl in comparison with 50 patients with serum creatinine < or = 1.5 mg/dl. Among 72 patients, GFR > 90 ml/min, calculated with Barasckay's formula, was stated only in 9 patients (12.5%). There was no difference in nephrotoxity between kappa and lambda light chains with reference to serum creatinine concentration and GFR. The group of 12 patients with light chain dyscrasia (LCD) had higher degree of nephrotoxicity in comparison with other forms of PCD. On the basis of our study we concluded that patients with clinical suspicion of PCD, especially those with LCD are referred to a special Protein Laboratory too late, it means at the time of significant nephrological risk in the form of low glomerular filtration rate, hypercalcemia and hyperuricemia.