Evidence map›Paper›PMID 28728609›Full record

Trial reportBMC nephrology2017

Multiple myeloma can be accurately diagnosed in acute kidney injury patients using a rapid serum free light chain test.

Jennifer L J Heaney, John P Campbell, Punit Yadav, Ann E Griffin, Meena Shemar, Jennifer H Pinney, Mark T Drayson

Open access · goldAbstract readClinical Trial
In one paragraph

Trial report in BMC nephrology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.6field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 15 citations in OpenAlex.

  1. Acute Kidney Injury in Monoclonal Gammopathies.Journal of clinical medicine · 2021
    Review
  2. Article
  3. Article
  4. The Paraprotein - an Enduring Biomarker.The Clinical biochemist. Reviews · 2019
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Jennifer L J HeaneyInstitute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, B15 2TT, Birmingham, UK.
John P CampbellInstitute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, B15 2TT, Birmingham, UK.
Punit YadavInstitute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, B15 2TT, Birmingham, UK.
Ann E GriffinInstitute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, B15 2TT, Birmingham, UK.
Meena ShemarAbingdon Health Ltd., York, UK.
Jennifer H PinneyInstitute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, B15 2TT, Birmingham, UK.
Mark T DraysonInstitute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, B15 2TT, Birmingham, UK. m.t.drayson@bham.ac.uk.
University of Birmingham · GBAbingdon Health (United Kingdom) · GBUniversity of Bath · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute kidney injury (AKI) is common in patients with multiple myeloma (MM). Whether serum free light chain (sFLC) measurements can distinguish between myeloma and other causes of AKI requires confirmation to guide early treatment. A rapid and portable sFLC test (Seralite®) is newly available and could reduce delays in obtaining sFLC results and accelerate diagnosis in patients with unexplained AKI. This study evaluated the accuracy of Seralite® to identify MM as the cause of AKI.

methodsFLCs were retrospectively analysed in patients with AKI stage 3 as per KDIGO criteria (i.e. serum creatinine ≥354 μmol/L or those on dialysis treatment) (n = 99); 45/99 patients had a confirmed MM diagnosis.

resultsThe Seralite® κ:λ FLC ratio accurately diagnosed all MM patients in the presence of AKI: a range of 0.14-2.02 returned 100% sensitivity and specificity for identifying all non-myeloma related AKI patients. The sFLC difference (dFLC) also demonstrated high sensitivity (91%) and specificity (100%): an optimal cut-off of 399 mg/L distinguished between myeloma and non-myeloma AKI patients. We propose a pathway of patient screening and stratification in unexplained AKI for use of Seralite® in clinical practice, with a κ:λ ratio range of 0.14-2.02 and dFLC 400 mg/L as decision points.

conclusionsSeralite® accurately differentiates between AKI due to MM and AKI due to other causes in patients considered at risk of myeloma. This rapid test can sensitively screen for MM in patients with AKI and help inform early treatment intervention.

Indexed as

Acute Kidney InjuryAdultAgedAged, 80 and overBiomarkersFemaleHumansImmunoglobulin Light ChainsMaleMiddle AgedMultiple MyelomaRetrospective StudiesTime FactorsYoung AdultBiomarkersImmunoglobulin Light ChainsAcute kidney injuryMyelomaPatient screeningRenal impairmentSerum free light chain

Identifiers

PMID28728609
PMCPMC5520226
OpenAlexW2737254766

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.