Related Experiment Videos
Renal function in newly diagnosed multiple myeloma--a demographic study of 1353 patients. The Nordic Myeloma Study
L M Knudsen1, E Hippe, M Hjorth
1Department of Internal Medicine, Herlev Hospital Copenhagen, Denmark.
Abstract:
This study describes the occurrence of renal failure among 1353 newly diagnosed cases of multiple myeloma. Renal function was evaluated by serum creatinine concentration in 1353 cases, 31% of whom had renal failure at the time of diagnosis. In 1206 cases an estimation of creatinine clearance was made. When renal failure was defined by using creatinine clearance estimation, 49% had renal failure at the time of diagnosis. Renal failure was present in 24% of patients with an M component of IgG-, 31% of IgA- and 100% of IgD-type. 52% of patients with light chain disease had renal failure. The frequency of renal failure was similar in lambda- and kappa-light chain disease. Patients with a high excretion of Bence Jones protein in the urine (> 10 g/24 h) had renal failure significantly more often than patients with lower excretion. Renal failure was related to advanced disease; 41% of patients with stage III (Durie-Salmon) disease had renal failure. Renal failure was found in 45% of patients with hypercalcaemia. When estimated creatinine clearance was used as a predictor of renal function, the same trends were found as mentioned above. In addition, the proportion of patients with renal failure was found to increase with advancing age.
Insights
A significant proportion of multiple myeloma patients experience renal failure at diagnosis. Factors like M-component type, Bence Jones protein levels, advanced disease stage, hypercalcemia, and older age are associated with increased risk of kidney dysfunction.
Area of Science:
- Nephrology
- Hematology
- Oncology
Background:
- Multiple myeloma is a plasma cell malignancy.
- Renal failure is a common complication in multiple myeloma patients.
- Early identification of risk factors for renal failure is crucial for patient management.
Purpose of the Study:
- To determine the prevalence of renal failure in newly diagnosed multiple myeloma patients.
- To identify clinical and laboratory factors associated with renal failure at diagnosis.
- To evaluate the impact of different myeloma subtypes and disease characteristics on renal function.
Main Methods:
- Retrospective analysis of 1353 newly diagnosed multiple myeloma cases.
- Assessment of renal function using serum creatinine and estimated creatinine clearance.
- Evaluation of M-component type, Bence Jones protein excretion, disease stage, and serum calcium levels.
Main Results:
- 31% of patients had renal failure based on serum creatinine; 49% based on creatinine clearance.
- Renal failure prevalence varied by M-component type (IgD: 100%, Light Chain: 52%).
- High Bence Jones protein excretion, advanced disease stage (Stage III), hypercalcemia, and increasing age were linked to higher rates of renal failure.
Conclusions:
- Renal failure is highly prevalent at multiple myeloma diagnosis, particularly when assessed by creatinine clearance.
- Specific myeloma characteristics and clinical factors significantly increase the risk of renal impairment.
- These findings underscore the importance of comprehensive renal function assessment and risk stratification in newly diagnosed multiple myeloma patients.