The association of long-term kidney function decline with mortality in patients with multiple myeloma: Single-center...

Kidney dysfunction is a frequent complication of multiple myeloma (MM) and is associated with worse survival outcomes. Despite its prevalence, the prognostic value of long-term kidney function decline remains insufficiently explored. This study aimed to investigate the impact of the estimated glomerular filtration rate (eGFR) slope on survival in patients with MM.

A retrospective cohort study was conducted on 43 patients with MM treated at the University Medical Center Maribor between 2015 and 2020, with a minimum follow-up of 1 year. Kidney function was assessed quarterly using eGFR. Kaplan-Meier analysis and Cox regression were applied to evaluate the association between eGFR slope and overall survival.

The median baseline eGFR was 52.8 mL/min/1.73m² (interquartile range: 35.2 - 78.1), with 39.5% of patients classified as having stage 3 or worse chronic kidney disease. We observed an association between faster annual eGFR slope decline and increased mortality (log-rank; p < 0.001). Cox regression confirmed eGFR slope as an independent predictor of mortality (hazard ratio = 1.121, 95% confidence interval: 1.069 - 1.174, p < 0.001). Additional prognostic factors included a lower platelet count.

Kidney function decline is an independent prognostic factor in patients with MM. Regular monitoring and early nephrology intervention may help mitigate its impact. Future research should focus on targeted strategies to slow kidney function deterioration and improve patient outcomes.