MO222DO WE OFTEN THINK OF MULTIPLE MYELOMA AS THE CAUSE OF KIDNEY DISEASE?. (29th May 2021)

• Record Type: Journal Article
• Authors: Pešić, Snezana; Grujic, Nevena; Stopić, Bojan; Janković, Aleksandar; Markovic, Katarina; Damjanovic, Tatjana; Naumovic, Radomir
• Is Part Of: Nephrology dialysis transplantation. Volume 36(2021)Supplement 1
• Publication Date: 2021-05-29
• Subjects: Nephrology -- Periodicals; Hemodialysis -- Periodicals; Kidneys -- Transplantation -- Periodicals; Hemodialysis; Kidneys -- Transplantation; Nephrology; Periodicals; 616.61
• DOI: 10.1093/ndt/gfab092.00100
• Languages: English
• ISSNs: 0931-0509

Abstract

Abstract: Background and Aims: Kidney disease is a common complication in patients with multiple myeloma and other plasma cell dyscrasias. This disease can be manifested by various kidney disorders, which can evolve as either an acute or chronic disorder. Cast nephropathy is the most common cause of severe acute kidney injury (AKI) in patients with multiple myeloma. Among newly diagnosed patients, 20 to 50 % have AKI or cronic kidney disease (CKD) at the time of diagnosis. Treatment of acute renal failure consists of good supportive care and anti-myeloma therapy. Introduction of novel agents has considerably improved outcome in patients with multiple myeloma and renal failure. The aim of this study was to identify the most common risk factors (RF) for mortality in patients with MM and renal failure. Method: The study included 22 patients ( mean years 67 ± 12 years, 12 men). Who followed two years. We analyzed routine laboratory tests, Bence Jones protein, urinary protein excretion, and creatinine clearance. Plain radiography for the evaluation of skeleton lesions were performed for all patients. Results: Overall two years mortality of patients with MM was 38.1% with no significant difference regard to patients' age and gender. About 33% of patients required renal replacement therapy and 19% remained on a chronic dialysis treatment program. Renal biopsy was performed in 9.1% of patients (1 - FSGS, 1 - LCCD, light chain deposition disease). Bone marrow transplant (stem cell transplant) was performed in 9.1% of patients. Of the associated comorbidities, 19% had DM, 81% had hypertension, CVD 52.4%. Osteolytic changes at the time of diagnosis were present in 52.4%. In older patients, kappa chains have been identified to a much more extent. Survival is significantly lower in dialysis dependent patients with a two-year survival of 30%. Binary logistic regression revealed that platelet decrease (OR = 0.982< CI 0.961–1.003< p = 0.09) and increase of IgA significantly influenced mortality (OR = 103, 867< CI 0.459–23567.201< p = 0.09) can be considered as potential predictors of mortality. Comorbidity DM, HTA, CVD were not the predictors for mortality in patients with MM Conclusion: Multiple myeloma associated with high mortality rate and kidney disease. High percentage of patients required renal replacement therapy (33%) and 19% remained on a chronic dialysis treatment program. Among the estimated parameters, the risk factors for mortality were significant decrease of platelet (p = 0.09) and increase IgA (p = 0.09). Survival is significantly lower in in dialysis dependent patients with a two-year survival of 30%.