Abstract
Background: This study aimed to describe the baseline renal, histopathological and hematological characteristics and any clinical or biochemical associations of patients with a first coded diagnosis of multiple myeloma (MM). The incidence of renal replacement therapy (RRT) and association with mortality were also investigated.
Methods: A retrospective case review was performed to identify 287 MM patients from two European centers. Statistical analyses were performed using SPSS version 2.0 and SAS version 9.2.
Results: MM patients referred to renal centers were more likely to be elderly and male. The most common form of renal impairment was acute kidney injury (AKI). The most common paraprotein-associated lesions were myeloma cast nephropathy (MCN, 51%), light chain deposition disease (17%) and AL-amyloidosis (9.4%). MM with AKI was found to be a more aggressive disease, being associated with worse hematological features and increased risk of short-term death. Of the AKI patients requiring RRT, 80% required it at presentation. There was no increased risk of death in the RRT requiring vs. non-RRT requiring cohort. Monoclonal gammopathy of undetermined significance (MGUS) may predispose to renal damage and may increase likelihood of AKI in context of MM.
Conclusion: MM-related renal failure is a medical emergency with the need for rapid diagnosis and prompt supportive care, RRT and MM-directed therapy.
Methods: A retrospective case review was performed to identify 287 MM patients from two European centers. Statistical analyses were performed using SPSS version 2.0 and SAS version 9.2.
Results: MM patients referred to renal centers were more likely to be elderly and male. The most common form of renal impairment was acute kidney injury (AKI). The most common paraprotein-associated lesions were myeloma cast nephropathy (MCN, 51%), light chain deposition disease (17%) and AL-amyloidosis (9.4%). MM with AKI was found to be a more aggressive disease, being associated with worse hematological features and increased risk of short-term death. Of the AKI patients requiring RRT, 80% required it at presentation. There was no increased risk of death in the RRT requiring vs. non-RRT requiring cohort. Monoclonal gammopathy of undetermined significance (MGUS) may predispose to renal damage and may increase likelihood of AKI in context of MM.
Conclusion: MM-related renal failure is a medical emergency with the need for rapid diagnosis and prompt supportive care, RRT and MM-directed therapy.
| Original language | English |
|---|---|
| Pages (from-to) | 8-16 |
| Journal | Journal of Hematology |
| DOIs | |
| Publication status | Published - 2016 |