Urinary proteins in multiple myeloma: correlation with clinical parameters and diagnostic implications
A Corso1, P Zappasodi2, C Pascutto2
1Institute of Hematology, IRCCS Policlinico San Matteo, University of Pavia, 27100, Pavia, Italy. a.corso@smatteo.pv.it.
Annals of Hematology
|July 3, 2003
Summary
Early detection of kidney damage in multiple myeloma (MM) patients is vital. Urinary proteins like IgG, alpha(1)-microglobulin, and albumin are more sensitive indicators of renal dysfunction than traditional serum markers.
Area of Science:
- Nephrology
- Hematology
- Oncology
Background:
- Renal failure is a severe complication in multiple myeloma (MM).
- Early diagnosis of renal dysfunction is critical for MM patient survival.
- Traditional markers like serum creatinine and urea may not detect early renal damage.
Purpose of the Study:
- To evaluate the sensitivity of urinary proteins in detecting early renal dysfunction in MM patients.
- To compare the diagnostic utility of urinary proteins versus serum markers for renal health in MM.
- To assess the correlation between urinary protein levels and MM disease parameters.
Main Methods:
- Studied renal function in 111 MM patients using serum creatinine, urea, and urinary IgG, alpha(1)-microglobulin (alpha(1)-M), and albumin (Alb).
- Performed serial monitoring in 30 patients, categorizing them into improved, stable, or worsened groups based on tumor burden markers.
- Analyzed correlations between urinary protein levels, serum markers, and clinical MM parameters (monoclonal component, bone marrow plasmacytosis, beta(2)-microglobulin).
Main Results:
- Renal dysfunction was detected in 17% of patients using serum markers but in 64.5% using urinary proteins.
- Urinary proteins (IgG, alpha(1)-M, Alb) showed significant correlations with each other and with serum creatinine and urea.
- Urinary proteins correlated with MM disease parameters: alpha(1)-M with bone marrow plasmacytosis and beta(2)-microglobulin; IgG with all three parameters; Alb with beta(2)-microglobulin.
Conclusions:
- Urinary IgG, alpha(1)-microglobulin, and albumin are sensitive and reliable biomarkers for early detection of renal damage in MM patients.
- Routine monitoring of these urinary proteins is recommended for defining and managing renal function in MM, especially in early stages.
- This approach aids in identifying initial signs of renal progression, potentially improving patient outcomes.
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