Risk Factors for Renal Failure in Patients with Newly Diagnosed Multiple Myeloma

Introduction:
Up to 50% of newly diagnosed multiple myeloma patients present with acute renal injury secondary to the neoplasia, which is produced by multifactorial events, being tubular damage and direct toxicity of tubular cells the most-understood mechanisms. The need for renal replacement therapy at diagnosis has been described in approximately 10% of these patients. However, in some cases kidney damage is irreversible, requiring long-term dialysis therapy, altering the quality of life of patients with myeloma and limiting treatment options. Likewise, the requirement for renal replacement therapy is today a known risk factor for worse outcomes in patients with multiple myeloma, negatively impacting the overall survival of patients. Recognizing risk factors for renal failure secondary to myeloma as a need for aggressive rapid intervention may affect the evolution of the disease and the patient's recovery process.
Methods:
This was an observational, cross-sectional study with an analytical component, which aimed to explore the outcome of renal replacement therapy for kidney disease secondary to multiple myeloma. We did a retrospective research of clinical records of patients. Patients'past medical history, CRAB criteria at the onset of the disease, malignant cells' immunophenotype and therapy offered were all assessed.
Results:
189 patients were diagnosed and treated between 2013 and 2020. Most of the patients were women. The average age was 67.2‚Äâyears. Median serum creatinine at diagnosis was 3 gr/dL, and renal survival at 6 months was 28%. Hemoglobin level was associated to requirement of renal replacement therapy. ISS staging showed significant differences (p Discussion:
Kidney injury at multiple myeloma diagnosis implies a worse prognosis. We identified laboratory and immunophenotype factors that were associated with a higher risk of developing renal injury. We believe the identification of these poor prognostic factors in patients with MM at the onset of disease allows a closer follow-up of these patients. Early interventions to minimize the risk of end-stage renal failure should be offered.