The use of immunoglobulin light chain assays in the diagnosis of paraprotein-related kidney disease

Kidney Int. 2015 Apr;87(4):692-7. doi: 10.1038/ki.2014.333. Epub 2014 Oct 8.


Kidney involvement is common in paraprotein-related diseases. A diversity of clinical presentations and histopathological features can occur secondary to tissue injury caused by precipitation or deposition of a clonal immunoglobulin, usually an immunoglobulin light chain. The paraprotein is either produced by multiple myeloma or by a clone of B-cell lineage that does not fulfill diagnostic criteria for multiple myeloma. The recent introduction of serum immunoglobulin free light chain assays, which accurately quantify both light chain isotypes to produce a ratio that indicates the presence or absence of a light chain paraprotein, is a major clinical development. However, as the interpretation of the assay can be challenging, the aim of this review is to clarify the role of serum and urinary light chain assays in the screening and diagnosis of paraprotein-related kidney disease.

Publication types

  • Review

MeSH terms

  • Glomerular Filtration Barrier
  • Hematologic Tests / methods
  • Humans
  • Immunoglobulin Light Chains / blood*
  • Immunoglobulin Light Chains / urine*
  • Paraproteinemias / complications
  • Paraproteinemias / diagnosis*
  • Reference Values
  • Renal Insufficiency / diagnosis*
  • Renal Insufficiency / etiology
  • Sensitivity and Specificity
  • Urinalysis


  • Immunoglobulin Light Chains