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Cardiovascular Comorbidities and Advanced Chronic Kidney Disease in Hospitalized Patients with Multiple Myeloma: A
Lavinia Alice Bălăceanu1,2, Andreea Taisia Tiron1,3, Ion Daniel Baboi1,4
1Clinical Department 1-Medical Semiology, "Carol Davila" University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Insights
Hospitalized multiple myeloma patients often have advanced chronic kidney disease (CKD) and cardiovascular issues. Atrial fibrillation and myocardial ischemia showed initial links to advanced CKD, but further analysis weakened these associations.
Area of Science:
- Nephrology
- Cardiology
- Hematology
Background:
- Coexistence of advanced chronic kidney disease (CKD) and cardiovascular comorbidities is frequent in multiple myeloma patients, especially those hospitalized.
- The clinical relationship between these conditions in routine practice is not fully understood.
Purpose of the Study:
- To investigate the association between cardiovascular comorbidities and advanced CKD in hospitalized multiple myeloma patients.
- To characterize the prevalence of these conditions in this patient population.
Main Methods:
- Retrospective cohort study of 137 hospitalized multiple myeloma patients (Jan 2015-Feb 2026).
- Advanced CKD defined as eGFR < 30 mL/min/1.73 m2 using CKD-EPI 2021.
- Logistic regression models assessed associations between cardiovascular comorbidities and advanced CKD.
Main Results:
- Advanced CKD (eGFR < 30) was present in 47.4% of patients.
- Common cardiovascular comorbidities included hypertension (76.4%), myocardial ischemia (74.5%), heart failure (45.5%), and diabetes mellitus (32.7%).
- Univariate analysis showed associations between advanced CKD and atrial fibrillation (OR 4.43) and myocardial ischemia (OR 2.89). Multivariable analysis did not confirm statistical significance.
Conclusions:
- Advanced CKD and cardiovascular comorbidities are highly prevalent in hospitalized multiple myeloma patients.
- While univariate analysis suggested links between atrial fibrillation, myocardial ischemia, and advanced CKD, these were not sustained in multivariable models.
- Findings highlight the frequent co-occurrence of these conditions, informing clinical practice.
Background:
Advanced chronic kidney disease (CKD) and cardiovascular comorbidities frequently coexist in patients with multiple myeloma and are particularly common among hospitalized patients. However, the relationship between common cardiovascular comorbidities and advanced CKD in routine clinical practice remains incompletely characterized.
Methods:
We conducted a retrospective single-center cohort study including 137 hospitalized patients diagnosed with multiple myeloma between January 2015 and February 2026. Demographic, clinical, and laboratory data were extracted from electronic medical records. Advanced CKD was defined as eGFR < 30 mL/min/1.73 m2, calculated using the CKD-EPI 2021 equation. Patients with isolated acute kidney injury were excluded. Cross-sectional associations between cardiovascular comorbidities and advanced CKD were assessed using logistic regression models.
Results:
The median age was 69 years (IQR 63-77), and 56.9% of patients were women. Renal impairment was common, with a median creatinine level of 2.82 mg/dL and a median eGFR of 22.4 mL/min/1.73 m2. Advanced CKD was identified in 55 of 116 patients (47.4%) with available CKD classification. Cardiovascular comorbidities were common, including hypertension (42/55, 76.4%), diabetes mellitus (18/55, 32.7%), myocardial ischemia (41/55, 74.5%), and heart failure (25/55, 45.5%). In univariate analysis, atrial fibrillation showed a significant cross-sectional association with advanced CKD (OR 4.43, 95% CI 1.30-15.07, p = 0.017), as was myocardial ischemia (OR 2.89, 95% CI 1.07-7.80, p = 0.039). In multivariable analysis, atrial fibrillation demonstrated a trend toward an association with advanced CKD but did not remain statistically significant after adjustment.
Conclusions:
Advanced CKD and cardiovascular comorbidities frequently coexist in hospitalized patients with multiple myeloma. Atrial fibrillation and myocardial ischemia were associated with advanced CKD in univariate analyses; however, these associations were attenuated after multivariable adjustment. Overall, these findings provide insight into the coexistence of advanced CKD and cardiovascular comorbidities in hospitalized patients with multiple myeloma.
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