Electrophoretic Patterns of Serum Proteins in a Chronic Hemodialysis Population

Abstract

Objective: This study aimed to explore the benefit of monitoring patients on maintenance hemodialysis with serum protein electrophoresis (SPE) as a low-cost biologic test. Patients and Methods: It is a mono-center retrospective study, conducted between January 2017 and December 2020 among 100 patients at maintenance hemodialysis. The patients' blood was collected after the hemodialysis session, and was analyzed for various biological tests. The electrophoresis of serum proteins was analyzed by the Capillarys system from Sebia. Results: Serum protein electrophoresis was normal in 36% of cases, showed an inflammatory syndrome in 24% of cases, hypergammaglobulinemia in 19% of patients, severe malnutrition profile in 13% of patients, anemic profile (8%) and nephrotic profile in 5% of cases. The combined analysis of anthropometric parameters, C-reactive protein, total cholesterol, albumin and serum protein electrophoresis results diagnose the complex inflammation malnutrition in 18% of patients. The presence of an inflammatory syndrome at the SPE was associated with a positive CRP in 65% of cases (p = 0.002). The mean value of Albumin (g/l) with biochemical assay (bromocresol green method BCG) is 39,8±3,83 versus 38,54±4,59 obtained with electrophoretic measurement. The discrepancy was observed more in the low concentrations of albumin (20 patients presented hypoalbuminemia in the SPE method versus 9% in the BCG method). Conclusion: Serum protein electrophoresis is an inexpensive biological test that allows monitoring of protein metabolism in chronic hemodialysis patients. The diagnosis of inflammation and malnutrition sometimes lacks sensitivity or specificity, but the SPE is the test of choice for the diagnosis of monoclonal gammapathy.