Analysis of urine biomarkers of renal tubular damage

• Research type

  Research Study

• Full title

  Analysis of urine biomarkers of renal tubular damage in patients with paraproteinaemia

• IRAS ID

  133934

• Contact name

  Angela Woods

• Contact email

  angelawoods@nhs.net

• Sponsor organisation

  East and North Herts NHS Trust

• Research summary

  A study of the presence of a urine protein biomarker (alpha-1-microglobulin, A1M) in patients with paraproteinaemia.

  A significant number of patients with paraproteinaemia (including myeloma and MGUS (monoclonal gammopathy of uncertain significance)) either present with, or go on to develop renal failure, through a number of pathological mechanisms [1, 2]. Currently renal function in these patients is monitored by serum creatinine and estimated glomerular filtration rate (eGFR), according to the Joint British Committee for Standards in Haematology/UK Myeloma Forum guidelines and NICE Chronic Kidney Disease guidelines [3, 4]. However, due to the reserve capacity of the kidney, serum creatinine and eGFR may not demonstrate early renal tubular dysfunction until a significant degree of damage has occurred [5]. Therefore earlier detection of tubular damage could be beneficial.

  During the study alpha-1-microglobulin and microalbumin in the urine of patients with paraprotein will be measured, and the results compared to the levels of alpha-1-microglobulin and microalbumin in patients without paraprotein. Alpha-1-microglobuiln is a small protein that has been shown to demonstrate renal tubular damage in cases of heavy metal nephrotoxicity [6, 7]. Microalbumin is an established marker of glomerular damage. The secondary aim of the study is the measurement of creatinine levels in patients in both groups, and comparison to levels of alpha-1-microglobulin and microalbumin.

  References:
  1. Augustson B et al., J Clin Oncol, 2005, v.23, 9219 - 9226
  2. Heher E et al., Blood, 2010, v.116, 9, 1397 - 1404
  3. BCSH and UKMF Guidelines on the Management and Diagnosis of Multiple Myeloma Sept 2010
  4. NICE Chronic Kidney Disease, 2008
  5. Parikh C et al., Ann Clin Biochem, 2010, v.47, 301 - 312
  6. Yu H et al., J Clin Pathol, 1983, v.36, 253 - 259
  7. Pless-Mulloli T et al., Occup Environ Med, 1998, v.55, 440 - 445

• REC name

  East Midlands - Leicester South Research Ethics Committee

• REC reference

  13/EM/0403

• Date of REC Opinion

  18 Oct 2013

• REC opinion

  Favourable Opinion