Multiple myeloma and renal failure: one center's experience

Area of Science:

• Nephrology
• Hematology
• Oncology

Background:

• Renal involvement is a significant complication of multiple myeloma.
• It is particularly prevalent in advanced stages of the disease.

Purpose of the Study:

• To analyze the presentation, treatment, and outcomes of multiple myeloma patients with renal complications.
• To understand the impact of renal failure on survival and quality of life in these patients.

Main Methods:

• Retrospective analysis of 34 multiple myeloma patients treated between 1987 and 1996.
• Review of patient data including diagnosis, renal biopsy findings, disease stage, complications, and treatment.
• Assessment of renal function, dialysis requirements, and survival rates.

Main Results:

• Most patients (76%) were diagnosed with myeloma only after referral for renal issues.
• Myeloma cast nephropathy was the primary histological finding in 62% of biopsied patients.
• Severe renal failure (GFR < 20 mL/min) was present in 91%, with 82% requiring dialysis shortly after admission.
• Advanced disease (Durie-Salmon stage II/III) was common (85%).
• Median overall survival was 5 months; sepsis and dialysis withdrawal were main causes of death.
• Long-term dialysis (median survival 8 months) offered survival beyond 12 months for 26% of patients, with good quality of life.

Conclusions:

• Multiple myeloma frequently presents with severe renal failure, often diagnosed late.
• Myeloma cast nephropathy is the predominant cause of renal damage.
• While overall survival is poor, long-term renal replacement therapy can provide a good quality of life for a subset of patients.