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Published on: July 19, 2018
Severe renal failure in multiple myeloma
Clinical Nephrology
|April 1, 1981
Summary
Multiple myeloma patients with kidney failure requiring dialysis had poor survival rates, especially with high calcium levels. Peritoneal dialysis and absence of light chain disease improved kidney function recovery.
Area of Science:
- Nephrology
- Hematology
- Oncology
Background:
- Multiple myeloma frequently causes kidney disease, often necessitating dialysis.
- Renal failure is a common presenting symptom in multiple myeloma patients.
- The impact of dialysis modality and myeloma-specific factors on renal recovery and survival is critical.
Purpose of the Study:
- To analyze the outcomes of multiple myeloma patients with end-stage renal disease requiring dialysis.
- To identify factors associated with renal function recovery in this patient cohort.
- To compare survival rates of myeloma patients on dialysis with general myeloma and non-myeloma dialysis populations.
Main Methods:
- Retrospective analysis of 24 multiple myeloma patients requiring dialysis.
- Evaluation of presenting symptoms, diagnostic procedures, dialysis modality, and serum calcium levels.
- Comparison of survival data with relevant control groups.
Main Results:
- Most patients presented with renal failure, with myeloma diagnosed later.
- Intravenous pyelography led to irreversible renal failure in 2 patients.
- Absence of light chain disease and use of peritoneal dialysis correlated with better renal recovery.
- One-year survival for myeloma patients on dialysis was similar to the general myeloma population but significantly worse than age-matched non-myeloma dialysis patients.
- Elevated serum calcium levels were associated with diminished survival.
Conclusions:
- Multiple myeloma with renal failure presents a poor prognosis, particularly with hypercalcemia.
- Peritoneal dialysis and absence of light chain disease may improve renal outcomes.
- Careful consideration of diagnostic procedures like intravenous pyelography is warranted.
- Myeloma patients on dialysis have a poorer survival than non-myeloma dialysis patients.
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