title: Higher serum levels of free ĸ plus λ immunoglobulin light chains ameliorate survival of hemodialysis patients.
abstract: OBJECTIVE
  Impaired immune function is common in patients with chronic renal failure. Now, we determined whether serum levels of free immunoglobulin light chains predict mortality in patients with chronic kidney disease stage 5 on hemodialysis.
  
  
  METHODS
  We performed a prospective cohort study of 160 hemodialysis patients with a median follow-up of 15 months (interquartile range, 3-44 months). Serum levels of free κ and λ immunoglobulin light chains were measured at the start of the study. The primary end point was mortality from any cause.
  
  
  RESULTS
  In survivors, median serum levels of free κ plus λ immunoglobulin light chains were significantly higher compared with nonsurvivors (p < 0.05). Survival was significantly longer in those patients who had serum levels of free κ plus λ immunoglobulin light chains above the median compared with patients with serum levels below the median of 210 mg/l (χ(2) = 5.91; p = 0.015 by log-rank, Mantel-Cox, test). We performed univariate and multivariate regression analysis showing that older age and lower serum levels of free κ plus λ immunoglobulin light chains predicted mortality in hemodialysis patients.
  
  
  CONCLUSIONS
  Higher serum levels of free κ plus λ immunoglobulin light chains ameliorate survival in hemodialysis patients.
authors.affiliation: Med. Klinik Nephrologie, Charité Campus Benjamin Franklin, Berlin, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Thilo
authors.forename: Christina
authors.initials: C
authors.lastname: Caspari
authors.forename: Alexandra
authors.initials: A
authors.lastname: Scholze
authors.forename: Martin
authors.initials: M
authors.lastname: Tepel
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007145:Immunoglobulin kappa-Chains / Q000097:blood*; D007146:Immunoglobulin lambda-Chains / Q000097:blood*; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D006435:Renal Dialysis / Q000401:mortality* / Q000639:trends; D015996:Survival Rate / Q000639:trends
chemical_list: D015415:Biomarkers; D007145:Immunoglobulin kappa-Chains; D007146:Immunoglobulin lambda-Chains