Abstract: TH-PO0625
Serum Combined Free Light Chains and Risk of Kidney Failure and Mortality
Session Information
- CKD: Clinical - Guidelines, Biomarkers, Progression, Procedures, Outcomes, and More
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2202 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Erkek, Merve, Ankara Universitesi Dahili Tip Bilimleri, Ankara, Ankara, Turkey
- Kumru, Gizem, Ankara Universitesi Dahili Tip Bilimleri, Ankara, Ankara, Turkey
- Kutlay, Sim, Ankara Universitesi Dahili Tip Bilimleri, Ankara, Ankara, Turkey
- Sengul, Sule, Ankara Universitesi Dahili Tip Bilimleri, Ankara, Ankara, Turkey
Background
The prognostic significance of serum free light chains (FLCs) remains not sufficiently delineated in kidney diseases. The predictive relevance of serum combined FLC (cFLC) levels in individuals with acute and chronic kidney injury was assessed in this study.
Methods
This retrospective cohort analysis involved 1,268 patients classified as chronic kidney disease (75.2%), acute kidney injury (5.3%), acute-on-chronic kidney disease (ACKD; 6.1%), and controls (13.5%) from June 2016 to May 2019. Serum cFLC levels were categorized into quartiles (<42.75, 42.75-66.49, 66.50-120.5, >120.5 mg/L). Independent predictors of increased cFLC levels, progression to end-stage kidney disease (ESKD), and mortality were analyzed.
Results
Patients with kidney injury had markedly elevated κ and λ FLCs, cFLC levels, and κ/λ ratios in comparison to the control group. The ACKD group exhibited the highest cFLC levels and the largest mortality risk (both p<0.001)(Figure-1A). Elevated cFLC levels correlated with enhanced systemic inflammation, indicated by increasing CRP levels, and deteriorating nutritional status, as demonstrated by declining serum albumin and hemoglobin levels. Multivariable models demonstrated that cFLC quartiles independently anticipated progression to ESKD(Table-1). Each 50 mg/L increase in cFLC levels was independently correlated with increased risk of mortality (HR,1.065;95%CI,1.009-1.125; p=0.022). A strong association between rising cFLC levels and mortality risk was demonstrated (log rank p<0.001) (Figure-1B).
Conclusion
Increased cFLC levels independently predict both progression to ESKD and mortality in individuals with kidney injury. Serum cFLC levels could be utilized as an accessible biomarker for risk stratification.
Kaplan-Meier plot showing cumulative survival.
Variables Associated with Progression to ESRD in Kidney Injury Group in Multivariate Analyses