Multiple Myeloma and Kidney Impairment at Diagnosis: A Nephrological Perspective from an Eastern European Country
<i>Background and Objectives</i>: 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...
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MDPI AG
2023-07-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/7/1326 |
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| author | Gabriel Ștefan Simona Cinca Corina Chiriac Adrian Zugravu Simona Stancu |
| author_facet | Gabriel Ștefan Simona Cinca Corina Chiriac Adrian Zugravu Simona Stancu |
| author_sort | Gabriel Ștefan |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: 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. <i>Materials and Methods</i>: 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. <i>Results</i>: 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. <i>Conclusions</i>: 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. |
| first_indexed | 2024-03-11T00:50:50Z |
| format | Article |
| id | doaj.art-640cb8549ba14f99b39d95ad6eea5d83 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-11T00:50:50Z |
| publishDate | 2023-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-640cb8549ba14f99b39d95ad6eea5d832023-11-18T20:25:11ZengMDPI AGMedicina1010-660X1648-91442023-07-01597132610.3390/medicina59071326Multiple Myeloma and Kidney Impairment at Diagnosis: A Nephrological Perspective from an Eastern European CountryGabriel Ștefan0Simona Cinca1Corina Chiriac2Adrian Zugravu3Simona Stancu4Faculty of Medicine, “Carol Davila” University of Medcine and Pharmacy, 050474 Bucharest, RomaniaFaculty of Medicine, “Carol Davila” University of Medcine and Pharmacy, 050474 Bucharest, RomaniaFaculty of Medicine, “Carol Davila” University of Medcine and Pharmacy, 050474 Bucharest, RomaniaFaculty of Medicine, “Carol Davila” University of Medcine and Pharmacy, 050474 Bucharest, RomaniaFaculty of Medicine, “Carol Davila” University of Medcine and Pharmacy, 050474 Bucharest, Romania<i>Background and Objectives</i>: 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. <i>Materials and Methods</i>: 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. <i>Results</i>: 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. <i>Conclusions</i>: 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.https://www.mdpi.com/1648-9144/59/7/1326multiple myelomamyeloma-related kidney injuryoverall survivalcast nephropathyend-stage kidney disease |
| spellingShingle | Gabriel Ștefan Simona Cinca Corina Chiriac Adrian Zugravu Simona Stancu Multiple Myeloma and Kidney Impairment at Diagnosis: A Nephrological Perspective from an Eastern European Country Medicina multiple myeloma myeloma-related kidney injury overall survival cast nephropathy end-stage kidney disease |
| title | Multiple Myeloma and Kidney Impairment at Diagnosis: A Nephrological Perspective from an Eastern European Country |
| title_full | Multiple Myeloma and Kidney Impairment at Diagnosis: A Nephrological Perspective from an Eastern European Country |
| title_fullStr | Multiple Myeloma and Kidney Impairment at Diagnosis: A Nephrological Perspective from an Eastern European Country |
| title_full_unstemmed | Multiple Myeloma and Kidney Impairment at Diagnosis: A Nephrological Perspective from an Eastern European Country |
| title_short | Multiple Myeloma and Kidney Impairment at Diagnosis: A Nephrological Perspective from an Eastern European Country |
| title_sort | multiple myeloma and kidney impairment at diagnosis a nephrological perspective from an eastern european country |
| topic | multiple myeloma myeloma-related kidney injury overall survival cast nephropathy end-stage kidney disease |
| url | https://www.mdpi.com/1648-9144/59/7/1326 |
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