Multiple Myeloma and Kidney Impairment at Diagnosis: A Nephrological Perspective from an Eastern European Country.

Abstract

Background and Objectives: The clinical presentation and survival factors in patients with myeloma-related kidney impairment (MRKI) at diagnosis remain a topic of ongoing research, given the complex interplay between nephrology and hematology. To date, no studies have specifically reported outcomes for these patients in Eastern Europe. Materials and Methods: We conducted a retrospective, unicentric study of consecutive newly diagnosed patients with MRKI in our tertiary nephrology service in Romania between 2015 and 2020; follow-up extended until 1 September 2022, covering a study period of 90 months. Results: We identified 89 consecutive patients with MRKI (median age 66 years, 38% male, median eGFR 5 mL/min). The majority of patients had arterial hypertension (71%) and systemic atherosclerosis (58%), and the most frequent clinical features at presentation were asthenia (75%) and bone pain (51%). Light-chain-restricted myeloma was the most common type (55%), with kappa free light chain being more frequent (53%). Among the patients, 81% presented with acute kidney injury (AKI), and 38% required hemodialysis at diagnosis. During the study period, 65% of the patients died, and hypoalbuminemia and the need for hemodialysis at diagnosis were significantly associated with mortality in multivariate analysis. Conclusions: Patients with MRKI who present to the nephrologist more frequently exhibit light chain restriction and most often present with AKI, with one-third requiring hemodialysis at diagnosis. Moreover, hypoalbuminemia and the initiation of hemodialysis at diagnosis were significantly associated with increased mortality.

• Authors: Gabriel Ștefan, Simona Cinca, Corina Chiriac, Adrian Zugravu, Simona Stancu
• Journal: Medicina (Kaunas, Lithuania) (Medicina (Kaunas)) Vol. 59 Issue 7 (Jul 18 2023) ISSN: 1648-9144 [Electronic] Switzerland
• PMID: 37512137 (Publication Type: Journal Article)

Chemical References

• Immunoglobulin kappa-Chains

Topics

• Humans
• Male
• Aged
• Female
• Multiple Myeloma (complications, diagnosis)
• Retrospective Studies
• Nephrology
• Hypoalbuminemia (complications)
• Acute Kidney Injury (complications)
• Immunoglobulin kappa-Chains
• Kidney