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Intensive haemodialysis using PMMA dialyser does not increase renal response rate in multiple myeloma patients with

Laurent Hudier1, Olivier Decaux2,3,4,5,6,7,8,9,10,11, Atmann Haddj-Elmrabet3

  • 1Centre hospitalier Broussais, Service de Néphrologie-Hémodialyse, Saint-Malo, France.

Clinical Kidney Journal
|April 13, 2018
PubMed
Abstract

Insights

Intensive haemodialysis (IHD) did not show a renal benefit over standard haemodialysis (SHD) for multiple myeloma (MM) patients with acute kidney injury. Achieving a hematologic response to chemotherapy was crucial for kidney recovery and improved patient survival.

Area of Science:

  • Nephrology
  • Hematology
  • Oncology

Background:

  • Multiple myeloma (MM) patients with acute kidney injury (AKI) may benefit from intensive hemodialysis (IHD) for rapid reduction of serum free light chains.
  • IHD alongside bortezomib-based chemotherapy could potentially improve renal outcomes and survival in MM patients.

Purpose of the Study:

  • To compare the efficacy of IHD versus standard hemodialysis (SHD) in MM patients with dialysis-dependent AKI undergoing bortezomib-based chemotherapy.
  • To evaluate the renal recovery rate as the primary outcome measure.

Main Methods:

  • Retrospective, multi-center study involving 41 MM patients with dialysis-dependent AKI.
  • Patients were divided into two groups: IHD (n=21) and SHD (n=20).
  • Primary endpoint was dialysis independence at 3 months.

Main Results:

  • No significant difference in dialysis independence at 3 months between IHD (38.1%) and SHD (35%) groups (P=1).
  • A significant association was observed between hematologic response to chemotherapy and dialysis independence (56% vs 6.3%, P=0.002).
  • The type of dialysis did not influence renal recovery in this cohort.

Conclusions:

  • Intensive hemodialysis (IHD) did not demonstrate a clear renal benefit compared to standard hemodialysis (SHD) in multiple myeloma patients with myeloma cast nephropathy.
  • Hematologic response to chemotherapy is a critical factor for renal recovery and overall prognosis in these patients.
  • Further research may be needed to explore optimal dialysis strategies in MM-related AKI.
Keywords:
PMMAhaematological responseintensive haemodialysismultiple myelomarenal response

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