Increased concentrations of free light chain lambda in sera from chronic hemodialysis patients.

Serum levels of FLc were determined in 5 pre-HD CRF patients, 63 CRF patients receiving HD therapy, 15 CAPD and 40 healthy volunteers. The highest serum FLc concentration was observed in patients receiving HD. Concentrations of kappa- and lambda FLc were higher than normal in patients with CRF, and were about 4-fold and 1.8 fold greater than control values in HD patients, with a predominance of lambda chains. This HD-associated elevation of serum FLc strongly suggests a role for FLc in the etiology of light chain deposit disease and AL-amyloidosis. Lambda-FLc and beta 2-m exhibited similar patterns of change in the serum during the course of HD therapy. Further studies may reveal other pathological conditions other than CRF in which these polypeptides may play a role.