What does the serum and urine immunofixation tests indicate?

Question

Hello doctor,

I am asking this question on behalf of my dad, who is 60 years old, 5 feet 9 inches, and 173 lbs. He was recently diagnosed with stage three chronic kidney disease. He also recently received an abnormal result on a serum immunofixation test, which I know can be an indicator of multiple myeloma, as well as other serious health conditions. However, his urine immunofixation test came back normal. His lab results also indicated that his PTH was high (92.5), his hematocrit was at the very lowest side of normal (41.0), and his Vitamin D was low (23). I was wondering what these results indicate, particularly with a normal urine immunofixation test and an abnormal serum immunofixation test?

Answer 1

Hello,

Welcome to icliniq.com.

As your dad has a chronic kidney disease, he is having nephropathy of the kidneys. We should look out for the cause. It could be high blood pressure or uncontrolled diabetes. He may require dialysis in the later stages.

In chronic kidney diseases, active conversion of vitamin D does not occur in the kidney, causing a vitamin D deficiency. It can lead to a calcium deficiency causing an increase in the secondary parathyroid hormone.

I suggest the following:

Calcium supplement.
Vitamin D tablet 5000 units, once daily for two months.

If serum electrophoresis shows a spike, then a bone marrow aspiration study can be done to rule out multiple myeloma.

For swelling, if present secondary to kidney condition, then a diuretic drug will be prescribed.

Take care. Hope this will help you. Consult a urologist for examination and further management of the chronic kidney disease.