Early Light Chains Removal and Albumin Levels with a Double Filter-Based Extracorporeal Treatment for Acute Myeloma Kidney

Renal impairment in Multiple Myeloma (MM) represents one of the most important factors that influences patient survival. In fact, before the introduction of modern chemotherapy, less than 25% of patients with acute kidney injury (AKI) and MM who required dialysis recovered sufficient renal function...

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Main Authors: Gabriele Donati, Fulvia Zappulo, Elisa Maietti, Anna Scrivo, Lorenzo Gasperoni, Elena Zamagni, Paola Tacchetti, Lucia Pantani, Olga Baraldi, Giorgia Comai, Maria Cappuccilli, Michele Cavo, Gaetano La Manna
Format: Article
Language:English
Published: MDPI AG 2022-06-01
Series:Toxins
Subjects:
Online Access:https://www.mdpi.com/2072-6651/14/6/391
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author Gabriele Donati
Fulvia Zappulo
Elisa Maietti
Anna Scrivo
Lorenzo Gasperoni
Elena Zamagni
Paola Tacchetti
Lucia Pantani
Olga Baraldi
Giorgia Comai
Maria Cappuccilli
Michele Cavo
Gaetano La Manna
author_facet Gabriele Donati
Fulvia Zappulo
Elisa Maietti
Anna Scrivo
Lorenzo Gasperoni
Elena Zamagni
Paola Tacchetti
Lucia Pantani
Olga Baraldi
Giorgia Comai
Maria Cappuccilli
Michele Cavo
Gaetano La Manna
author_sort Gabriele Donati
collection DOAJ
description Renal impairment in Multiple Myeloma (MM) represents one of the most important factors that influences patient survival. In fact, before the introduction of modern chemotherapy, less than 25% of patients with acute kidney injury (AKI) and MM who required dialysis recovered sufficient renal function to become independent from dialysis, with a median overall survival of less than 1 year. There are many other factors involved in determining patient survival. In this study we aimed to investigate the role of double filter-based extracorporeal treatment for removal of serum free light chains (sFLC) in acute myeloma kidney (AKI for MM) and to evaluate patient overall survival. All patients received Bortezomib-based chemotherapy and extracorporeal treatment for sFLC removal. For each session 2 dialyzers of the same kind were used. The dialytic dose was not related to the degree of renal function but to the removal of sFLC. The factors that have been found to be significantly associated with lower mortality were reduction of sFLC at day 12 and day 30, >50% reduction of sFLC at day 30, number of sessions and independence from dialysis. Among baseline characteristics, albumin level was statistically associated with the patients’ outcome. Our analysis highlights the importance of the early treatment for removal of sFLC in AKI for MM. These results indicate that the early removal of sFLC can improve patient’s outcome.
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spelling doaj.art-13978d971f404865be7c726f6955efdd2023-11-23T19:17:08ZengMDPI AGToxins2072-66512022-06-0114639110.3390/toxins14060391Early Light Chains Removal and Albumin Levels with a Double Filter-Based Extracorporeal Treatment for Acute Myeloma KidneyGabriele Donati0Fulvia Zappulo1Elisa Maietti2Anna Scrivo3Lorenzo Gasperoni4Elena Zamagni5Paola Tacchetti6Lucia Pantani7Olga Baraldi8Giorgia Comai9Maria Cappuccilli10Michele Cavo11Gaetano La Manna12Nephrology, Dialysis and Renal Transplantation Unit, Azienda Ospedaliero-Universitaria di Modena, Surgical, Medical, Dental and Morphological Sciences Department (CHIMOMO), University of Modena and Reggio Emilia, 41124 Modena, ItalyNephrology Dialysis and Renal Transplantation Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Experimental Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, 40138 Bologna, ItalyDepartment of Biomedical and Neuromotor Sciences-DIBINEM, University of Bologna, 40138 Bologna, ItalyNephrology Dialysis and Renal Transplantation Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Experimental Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, 40138 Bologna, ItalyNephrology Dialysis and Renal Transplantation Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Experimental Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, 40138 Bologna, ItalyHematology and Oncology Unit “Lorenzo & Ariosto Seràgnoli”, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Alma Mater Studiorum University of Bologna, 40138 Bologna, ItalyHematology and Oncology Unit “Lorenzo & Ariosto Seràgnoli”, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Alma Mater Studiorum University of Bologna, 40138 Bologna, ItalyHematology and Oncology Unit “Lorenzo & Ariosto Seràgnoli”, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Alma Mater Studiorum University of Bologna, 40138 Bologna, ItalyNephrology Dialysis and Renal Transplantation Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Experimental Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, 40138 Bologna, ItalyNephrology Dialysis and Renal Transplantation Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Experimental Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, 40138 Bologna, ItalyNephrology Dialysis and Renal Transplantation Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Experimental Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, 40138 Bologna, ItalyHematology and Oncology Unit “Lorenzo & Ariosto Seràgnoli”, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Alma Mater Studiorum University of Bologna, 40138 Bologna, ItalyNephrology Dialysis and Renal Transplantation Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Experimental Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum University of Bologna, 40138 Bologna, ItalyRenal impairment in Multiple Myeloma (MM) represents one of the most important factors that influences patient survival. In fact, before the introduction of modern chemotherapy, less than 25% of patients with acute kidney injury (AKI) and MM who required dialysis recovered sufficient renal function to become independent from dialysis, with a median overall survival of less than 1 year. There are many other factors involved in determining patient survival. In this study we aimed to investigate the role of double filter-based extracorporeal treatment for removal of serum free light chains (sFLC) in acute myeloma kidney (AKI for MM) and to evaluate patient overall survival. All patients received Bortezomib-based chemotherapy and extracorporeal treatment for sFLC removal. For each session 2 dialyzers of the same kind were used. The dialytic dose was not related to the degree of renal function but to the removal of sFLC. The factors that have been found to be significantly associated with lower mortality were reduction of sFLC at day 12 and day 30, >50% reduction of sFLC at day 30, number of sessions and independence from dialysis. Among baseline characteristics, albumin level was statistically associated with the patients’ outcome. Our analysis highlights the importance of the early treatment for removal of sFLC in AKI for MM. These results indicate that the early removal of sFLC can improve patient’s outcome.https://www.mdpi.com/2072-6651/14/6/391multiple myelomaacute kidney injurydouble dialysis filterPEPAPMMAfree light chains
spellingShingle Gabriele Donati
Fulvia Zappulo
Elisa Maietti
Anna Scrivo
Lorenzo Gasperoni
Elena Zamagni
Paola Tacchetti
Lucia Pantani
Olga Baraldi
Giorgia Comai
Maria Cappuccilli
Michele Cavo
Gaetano La Manna
Early Light Chains Removal and Albumin Levels with a Double Filter-Based Extracorporeal Treatment for Acute Myeloma Kidney
Toxins
multiple myeloma
acute kidney injury
double dialysis filter
PEPA
PMMA
free light chains
title Early Light Chains Removal and Albumin Levels with a Double Filter-Based Extracorporeal Treatment for Acute Myeloma Kidney
title_full Early Light Chains Removal and Albumin Levels with a Double Filter-Based Extracorporeal Treatment for Acute Myeloma Kidney
title_fullStr Early Light Chains Removal and Albumin Levels with a Double Filter-Based Extracorporeal Treatment for Acute Myeloma Kidney
title_full_unstemmed Early Light Chains Removal and Albumin Levels with a Double Filter-Based Extracorporeal Treatment for Acute Myeloma Kidney
title_short Early Light Chains Removal and Albumin Levels with a Double Filter-Based Extracorporeal Treatment for Acute Myeloma Kidney
title_sort early light chains removal and albumin levels with a double filter based extracorporeal treatment for acute myeloma kidney
topic multiple myeloma
acute kidney injury
double dialysis filter
PEPA
PMMA
free light chains
url https://www.mdpi.com/2072-6651/14/6/391
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