title: [Exploration of early assessment of renal impairment in multiple myeloma].
abstract: OBJECTIVE
  To investigate the value of serum cystatin C (Cys-C), urinary Cys-C, urinary retinol binding protein (RBP) and urinary neutrophil gelatinase-associated lipocalin (NGAL) in the early assessment of multiple myeloma (MM) and their characteristic changes in different pathological types of renal impairment.
  
  
  METHODS
  According to glomerular filtration rate (eGFR), the patients were divided into two groups, of which marked group A with normal renal function, the other marked group B with abnormal renal function. Sixty healthy subjects were chosen as control. Detection of the serum Cys-C, urinary RBP, urinary Cys-C, urinary NGAL, serum creatinine (Scr), urinary microalbumin (MAU) and urinary α1-microglobulin (α1-MG) were performed. Renal biopsy was carried out for patients who had abnormal serum Cys-C, urinary Cys-C, urinary RBP, urinary NGAL and were willing to accept further test.
  
  
  RESULTS
  Compared with healthy controls, the serum Cys-C, urinary RBP, urinary Cys-C, urinary NGAL of group A were significantly higher than that of healthy controls. Six group A patients received renal biopsy, and varying degrees of renal damage were discovered. The serum Cys-C, urinary RBP, urinary Cys-C and urinary NGAL positive rate were 66.7%, 66.7%, 66.7% and 83.3%, respectively. Of twenty-four cases received biopsy after abnormal examination results were shown, six turned out to be amyloidosis, twelve cast nephropathy (CN) and 6 monoclonal immunoglobulin deposition disease (MIDD). Compared with MIDD and amyloidosis, the urinary Cys-C and NGAL of the CN group are significantly higher (P < 0.05). Compared with CN and amyloidosis, urinary RBP of MIDD is significantly higher (P = 0.043). Compared with MIDD and CN, the MAU of amyloidosis is significantly higher (P = 0.006).
  
  
  CONCLUSIONS
  Compared with the conventional indicators, serum Cys-C, urinary Cys-C, RBP and NGAL are more sensitive in early assessment of MM patients with renal damage. The MAU is higher in amyloid, the urinary Cys-C and urinary NGAL are significantly elevated in CN, the urinary RBP is significantly elevated in MIDD.
authors: Department of Hematology, Second Military Medical Hospital, Shanghai, China.
authors: Yun
authors: Y
authors: Zhong
authors: Zhen-gang
authors: ZG
authors: Yuan
authors: Wei-jun
authors: WJ
authors: Fu
authors: Fan
authors: F
authors: Zhou
authors: Chun-yang
authors: CY
authors: Zhang
authors: Wen-hao
authors: WH
authors: Zhang
authors: Jian
authors: J
authors: Hou
mesh_terms: D000209:Acute-Phase Proteins / Q000652:urine; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D055316:Cystatin C / Q000097:blood / Q000652:urine; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology; D007674:Kidney Diseases / Q000097:blood / Q000175:diagnosis* / Q000652:urine; D007677:Kidney Function Tests; D000071068:Lipocalin-2; D054834:Lipocalins / Q000652:urine; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000473:pathology* / Q000652:urine; D011518:Proto-Oncogene Proteins / Q000652:urine; D012177:Retinol-Binding Proteins / Q000652:urine*
chemical_list: D000209:Acute-Phase Proteins; D055316:Cystatin C; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D012177:Retinol-Binding Proteins