eprintid: 10133224
rev_number: 22
eprint_status: archive
userid: 608
dir: disk0/10/13/32/24
datestamp: 2021-08-19 15:09:19
lastmod: 2021-10-15 23:04:31
status_changed: 2021-08-19 15:09:19
type: article
metadata_visibility: show
creators_name: Rezk, T
creators_name: Salota, R
creators_name: Gan, JJ
creators_name: Lachmann, HJ
creators_name: Fontana, M
creators_name: Siew, K
creators_name: Martinez-Naharro, A
creators_name: Guillotte, C
creators_name: Bass, P
creators_name: Sachchithanantham, S
creators_name: Mahmood, S
creators_name: Petrie, A
creators_name: Whelan, CJ
creators_name: Pinney, JH
creators_name: Dockrell, M
creators_name: Foard, D
creators_name: Lane, T
creators_name: Wechalekar, AD
creators_name: Hawkins, PN
creators_name: Walsh, SB
creators_name: Gillmore, JD
title: Urinary retinol binding protein predicts renal outcome in systemic immunoglobulin light-chain (AL) amyloidosis
ispublished: pub
divisions: UCL
divisions: B02
divisions: C10
divisions: D17
divisions: G90
divisions: G93
divisions: D21
keywords: Science & Technology, Life Sciences & Biomedicine, Hematology, amyloid, myeloma, chemotherapy, renal medicine
note: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and
distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
abstract: Summary:
Renal risk stratification in systemic immunoglobulin light-chain (AL) amyloidosis is according to estimated glomerular filtration rate (eGFR) and urinary protein creatinine ratio (uPCR), the latter attributed to glomerular dysfunction, with proximal tubular dysfunction (PTD) little studied. Urinary retinol binding protein 4 (uRBP), a low molecular weight tubular protein and highly sensitive marker of PTD, was prospectively measured in 285 newly diagnosed, untreated patients with systemic AL amyloidosis between August 2017 to August 2018. At diagnosis, the uRBP/creatinine ratio (uRBPCR) correlated with serum creatinine (r = 0·618, P < 0·0001), uPCR (r = 0·422, P < 0·0001) as well as both fractional excretion of phosphate and urate (r = 0·563, P < 0·0001). Log uRBPCR at diagnosis was a strong independent predictor of end-stage renal disease {hazard ratio [HR] 2·65, [95% confidence interval (CI) 1·06–6·64]; P = 0·038}, particularly in patients with an eGFR >30 ml/min/1.73 m2 [HR 4·11, (95% CI 1·45–11·65); P = 0·008] and those who failed to achieve a deep haematological response to chemotherapy within 3 months of diagnosis [HR 6·72, (95% CI 1·83–24·74); P = 0·004], and also predicted renal progression [HR 1·91, (95% CI 1·18–3·07); P = 0·008]. Elevated uRBPCR indicates PTD and predicts renal outcomes independently of eGFR, uPCR and clonal response in systemic AL amyloidosis. The role of uRBPCR as a novel prognostic biomarker merits further study, particularly in monoclonal gammopathies of renal significance.
date: 2021-08-09
date_type: published
publisher: WILEY
official_url: https://doi.org/10.1111/bjh.17706
oa_status: green
full_text_type: pub
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1882858
doi: 10.1111/bjh.17706
lyricists_name: Fontana, Marianna
lyricists_name: Gillmore, Julian
lyricists_name: Hawkins, Philip
lyricists_name: Lachmann, Helen
lyricists_name: Petrie, Aviva
lyricists_name: Rezk, Tamer
lyricists_name: Siew, Keith
lyricists_name: Walsh, Stephen
lyricists_name: Wechalekar, Ashutosh
lyricists_id: MFONT56
lyricists_id: JGILL78
lyricists_id: PNHAW77
lyricists_id: HJLAC80
lyricists_id: APETR26
lyricists_id: TMIRE17
lyricists_id: KSIEW63
lyricists_id: SBWAL99
lyricists_id: AWECH53
actors_name: Flynn, Bernadette
actors_id: BFFLY94
actors_role: owner
full_text_status: public
publication: British Journal of Haematology
pages: 8
citation:        Rezk, T;    Salota, R;    Gan, JJ;    Lachmann, HJ;    Fontana, M;    Siew, K;    Martinez-Naharro, A;                                                         ... Gillmore, JD; + view all <#>        Rezk, T;  Salota, R;  Gan, JJ;  Lachmann, HJ;  Fontana, M;  Siew, K;  Martinez-Naharro, A;  Guillotte, C;  Bass, P;  Sachchithanantham, S;  Mahmood, S;  Petrie, A;  Whelan, CJ;  Pinney, JH;  Dockrell, M;  Foard, D;  Lane, T;  Wechalekar, AD;  Hawkins, PN;  Walsh, SB;  Gillmore, JD;   - view fewer <#>    (2021)    Urinary retinol binding protein predicts renal outcome in systemic immunoglobulin light-chain (AL) amyloidosis.                   British Journal of Haematology        10.1111/bjh.17706 <https://doi.org/10.1111/bjh.17706>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10133224/1/bjh.17706.pdf