Abstract
Background and Objectives: Urine insulin-like growth factor-binding protein 7 (IGFBP-7), tissue inhibitor of matrix metalloproteinase 2 (TIMP-2), and neutrophil gelatinase-associated lipocalin (NGAL) monomer are novel tubular kidney injury biomarkers. In multiple myeloma (MM), immunoglobulin free light chains (FLCs) play an integral role in renal impairment. This study aimed to investigate the correlation between new biomarkers and acclaimed parameters of renal failure, MM stage, and prognosis. Materials and Methods: The examined parameters included: urinary and serum cystatin-C, IGFBP-7, and TIMP-2, and urinary NGAL monomer in 124 enrolled patients. Results: Urinary and serum IGFBP-7 and urinary NGAL were higher among patients with an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2, and positively correlated with urine light chains. Serum and urine IGFBP-7 and urine NGAL were greater among patients with a higher disease stage. In the whole study group, urinary concentrations of the studied markers were positively correlated with each other. In multiple linear regression, urinary IGFBP-7 and NGAL were associated with lower eGFR, independently of other urinary markers. Conclusions: Urinary IGFBP-7 and NGAL monomer may be useful markers of tubular renal damage in patients with MM. Biomarker-based diagnostics may contribute to earlier treatment that may improve renal outcomes and life expectancy in MM.
Highlights
Being one of the most common hematologic malignancies, in the elderly patient, multiple myeloma (MM) represents a devastating disease that occurs due to uncontrolled proliferation of a plasma cell in bone marrow
Disease Epidemiology Collaboration equation based on serum cystatin C; eGFR, estimated glomerular filtration rate; FLC, free light chains; IGFBP-7, insulin-like growth factor-binding protein 7; IQR, interquartile range; LC, light chains; NA, not applicable; ND, not detectable; NGAL, neutrophil gelatinase-associated lipocalin; NT-proBNP, N-terminal pro-brain natriuretic peptide; TIMP-2, tissue inhibitor of matrix metalloproteinase 2
We report p-values for significant differences between groups
Summary
Being one of the most common hematologic malignancies, in the elderly patient, multiple myeloma (MM) represents a devastating disease that occurs due to uncontrolled proliferation of a plasma cell in bone marrow. Production of monoclonal paraproteins, immunoglobulins (MIg) or free light chains (FLCs), is a characteristic feature of myeloma that is tied to its clinical manifestations. In multiple myeloma (MM), immunoglobulin free light chains (FLCs) play an integral role in renal impairment. Materials and Methods: The examined parameters included: urinary and serum cystatin-C, IGFBP-7, and TIMP-2, and urinary NGAL monomer in 124 enrolled patients. Results: Urinary and serum IGFBP-7 and urinary NGAL were higher among patients with an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 , and positively correlated with urine light chains. Urinary IGFBP-7 and NGAL were associated with lower eGFR, independently of other urinary markers. Conclusions: Urinary IGFBP-7 and NGAL monomer may be useful markers of tubular renal damage in patients with MM.
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