Korean J Med.  2014 Feb;86(2):190-197.

Risk Factors and Reversibility of Renal Failure in Patients with Newly Diagnosed Multiple Myeloma

• Whang HC
• Koh ES
• Kim JG
• Chung S
• Shin SJ
• Park CW
• Chang YS

Abstract

BACKGROUND/AIMS
Multiple myeloma (MM) is frequently accompanied by renal insufficiency, which has been regarded as a poor prognostic factor for MM. It is known that the incidence and characteristics of MM in Asia differ from those in Western countries. The aim of this study was to evaluate risk factors for renal impairment and to investigate reversible factors for renal failure in patients with MM.
METHODS
Patients newly diagnosed with MM from 2005 to 2008 were included. We investigated factors associated with renal insufficiency and those related to recovery from renal dysfunction after 12 weeks of treatment of MM.
RESULTS
Renal failure was recognized in 86 (39%) of 221 patients at diagnosis. In the binary logistic regression analysis, low hemoglobin (odds ratio [OR], 0.813; p = 0.02), high beta2microglobulin (OR, 1.006; p < 0.01), and use of angiotensin-converting enzyme inhibitors (ACEi) (OR, 2.783; p < 0.04) at initial presentation were independent risk factors for renal failure in patients with multiple myeloma. After 12 weeks of treatment, 25 of 86 (29%) patients with renal failure had recovered renal function. Good response to chemotherapy (OR, 6.044; p < 0.01) and higher eGFR (OR, 1.084; p < 0.01) were associated with renal function recovery.
CONCLUSIONS
Levels of hemoglobin and beta2microglobulin, and use of ACEi were independent risk factors for the development of renal failure in MM patients. The response to chemotherapy and eGFR at diagnosis significantly influenced recovery of renal function.

Keyword

Multiple myeloma; Renal insufficiency; Risk factors

MeSH Terms

Angiotensin-Converting Enzyme Inhibitors
Asia
Diagnosis
Drug Therapy
Humans
Incidence
Logistic Models
Multiple Myeloma*
Recovery of Function
Renal Insufficiency*
Risk Factors*
Angiotensin-Converting Enzyme Inhibitors