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Role of urine and serum protein electrophoresis in evaluation of nephrotic-range proteinuria.

Publication ,  Journal Article
Chew, ST; Fitzwilliam, J; Indridason, OS; Kovalik, EC
Published in: Am J Kidney Dis
July 1999

The usefulness of routine serum protein electrophoresis (SPEP) and urine protein electrophoresis (UPEP) screening in the evaluation of proteinuria is not known. The data on the clinical utility of these tests in 165 male patients with proteinuria greater than 3 g/d of protein who were screened for the presence of an M-spike are presented. Two hundred fifty-four studies were performed (SPEP, 155; UPEP 99) in these 165 patients. Twenty-four studies (9.8%) were positive for an M-spike (15 serum; 9 urine samples) in 19 patients (11.5%). Fourteen patients (8.5%) had an M-spike in either serum or urine, five patients (3%) in both studies. Two of these 19 patients were diagnosed with myeloma and 1 patient was diagnosed with primary amyloidosis. The other 16 patients were diagnosed with monoclonal gammopathy of unknown significance (MGUS). The group with a positive M-spike was significantly older (mean +/- SEM, 65 +/- 2 years; range, 39 to 78 years v 58 +/- 1 years; range, 25 to 84 years; P = 0.03), had a lower incidence of coexistent diabetes (21.1% v 61.6%; P = 0. 01), and a lower serum albumin level (3.2 v 3.6 g/dL; P = 0.05). Using a multivariable logistic regression model, the presence of an M band was positively correlated with age (odds ratio [OR], 1.056; 95% confidence interval [CI], 1.006 to 1.108) and negatively correlated for serum albumin level (OR, 0.386; 95% CI, 0.184 to 0. 810), hematocrit (OR, 0.923; 95% CI, 0.852 to 1.001), and the presence of diabetes mellitus (OR, 0.128; 95% CI, 0.038 to 0.434). In summary, routine SPEP and UPEP screening in patients with proteinuria greater than 3 g/d of protein detected an M-spike in 11. 5% and myeloma in 1.2% of the patients. The cost per case of myeloma or MGUS discovered was $1,192.

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Published In

Am J Kidney Dis

DOI

EISSN

1523-6838

Publication Date

July 1999

Volume

34

Issue

1

Start / End Page

135 / 139

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Retrospective Studies
  • Proteinuria
  • Paraproteinemias
  • Nephrotic Syndrome
  • Multiple Myeloma
  • Middle Aged
  • Mass Screening
  • Male
  • Logistic Models
 

Citation

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Chicago
ICMJE
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Chew, S. T., Fitzwilliam, J., Indridason, O. S., & Kovalik, E. C. (1999). Role of urine and serum protein electrophoresis in evaluation of nephrotic-range proteinuria. Am J Kidney Dis, 34(1), 135–139. https://doi.org/10.1016/s0272-6386(99)70119-8
Chew, S. T., J. Fitzwilliam, O. S. Indridason, and E. C. Kovalik. “Role of urine and serum protein electrophoresis in evaluation of nephrotic-range proteinuria.Am J Kidney Dis 34, no. 1 (July 1999): 135–39. https://doi.org/10.1016/s0272-6386(99)70119-8.
Chew ST, Fitzwilliam J, Indridason OS, Kovalik EC. Role of urine and serum protein electrophoresis in evaluation of nephrotic-range proteinuria. Am J Kidney Dis. 1999 Jul;34(1):135–9.
Chew, S. T., et al. “Role of urine and serum protein electrophoresis in evaluation of nephrotic-range proteinuria.Am J Kidney Dis, vol. 34, no. 1, July 1999, pp. 135–39. Pubmed, doi:10.1016/s0272-6386(99)70119-8.
Chew ST, Fitzwilliam J, Indridason OS, Kovalik EC. Role of urine and serum protein electrophoresis in evaluation of nephrotic-range proteinuria. Am J Kidney Dis. 1999 Jul;34(1):135–139.
Journal cover image

Published In

Am J Kidney Dis

DOI

EISSN

1523-6838

Publication Date

July 1999

Volume

34

Issue

1

Start / End Page

135 / 139

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Retrospective Studies
  • Proteinuria
  • Paraproteinemias
  • Nephrotic Syndrome
  • Multiple Myeloma
  • Middle Aged
  • Mass Screening
  • Male
  • Logistic Models