Prevalence Of Nephropathy In Multiple Myeloma Patients: An Experience Of Single Center

Multiple myelom (MM) is a plasma cell malignancy and is characterized by anemia, recurrent infections, serum and/or urine monoclonal protein, osteolytic bone lesions, hypercalcemia and renal failure. The prevalence of nephropathy varies between 20 and 50% in MM. In this study, the prevalence of nephropathy and related factors were aimed to investigate in MM patients who admitted to the Hematology and Nephrology clinics of Meram Faculty of Medicine, Necmettin Erbakan University. A total of 104 MM patients (F/M: 55/49) were retrospectively examined who were administered in the last five years. The mean follow up duration was 29 months. The mean age was 64±10.6 years. During the follow-up period, 30.8% of our patients died and 58% were still alive. The fate of the 10.6% of the patients could not be learned. Patients with serum creatinine ≥2 mg/dL were considered as patients with nephropathy. The vincristine-adriamycindexamethasone or melfelan-methylprednisolone (for patients >65 years) were administered as initial therapy. Statistical analysis was performed with SPSS 15.0. Renal involvements were observed in 33 patients (31.7%). Hyperuricemia (p=0.002), hypercalcemia (p=0.037), hypovolemia (p<0.001) and oliguria (p<0.001) were found to be higher in patients with creatinine ≥2 mg/dL. In 31 patients (29.8%), hemodialysis (HD) treatment was required, 19 of these (61.2% of HD patients, 18.2% of all patients) were treated with HD permanently. Mortality rates were found as %42 in patients with nephropathy and %25.3 without nephropathy (p=0.034). Renal failure is a poor prognostic marker in multiple myeloma. In this study one-third of MM patients had nephropathy requiring HD. Although renal insufficiency is mainly due to monoclonal light chain nephropathy, reversible causes such as hypovolaemia should be carefully evaluated. We think that particular attention should be paid to this group because of the increased risk of mortality.