Renal recovery after acute kidney injury requiring urgent hemodialysis is not associated with improved survival of the patients with multiple myeloma.
- Resource Type
- Academic Journal
- Authors
- Sulu C; Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Cerrahpaşa Medical School, Istanbul University-Cerrahpaşa, Kocamustafapasa Street No: 53, 34098, Fatih, Istanbul, Turkey. drcemsulu@yahoo.com.; Yalın SF; Division of Nephrology, Department of Internal Medicine, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul, Turkey.; Gürer T; Department of Internal Medicine, Cerrahpaşa Medical School, Istanbul University-Cerrahpaşa, Istanbul, Turkey.; Ar MC; Division of Hematology, Department of Internal Medicine, Cerrahpaşa Medical School, Istanbul University-Cerrahpaşa, Istanbul, Turkey.; Altıparmak MR; Division of Nephrology, Department of Internal Medicine, Cerrahpaşa Medical School, Istanbul University-Cerrahpaşa, Istanbul, Turkey.
- Source
- Publisher: Royal Academy of Medicine of Ireland Country of Publication: Ireland NLM ID: 7806864 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1863-4362 (Electronic) Linking ISSN: 00211265 NLM ISO Abbreviation: Ir J Med Sci Subsets: MEDLINE
- Subject
- Language
- English
Background: Severe acute kidney injury (AKI) requiring urgent hemodialysis (uHD) is associated with considerable morbidity and mortality in patients with multiple myeloma (MM).
Purpose: To evaluate the renal function, outcome, and survival status of patients with MM who received uHD and to compare their overall survival with MM patients who did not receive uHD.
Materials and Methods: A total of 70 eligible MM patients who received uHD were included together with 70 control patients with MM.
Results: In the study group, 11 patients (15.7%) were known to have pre-existing chronic kidney disease. Thirty-four percent of the study group had AKI requiring uHD at MM diagnosis. Seventy-eight percent of the study group had severe AKI due to myeloma kidney. Renal function recovered in 36 patients (51.4%). Patients with MM who became hemodialysis dependent had significantly higher serum creatinine (sCr) levels at the time of AKI compared to patients with renal recovery (p < 0.05). Logistic regression analysis showed that high sCr on admission was significantly associated with hemodialysis dependence (odds ratio 0.78; 95% CI: 0.63-0.96; p = 0.018). The median overall survival was 30 months [IQR: 26] in the study group and 84 months [IQR: 96.25] in the control group (p < 0.05). Cox regression analysis showed that the need for uHD at initial MM diagnosis was associated with reduced survival (hazard ratio (HR) 1.9; 95% CI: 1.1-3.2; p = 0.017). Renal recovery did not provide a survival benefit.
Conclusion: The need for uHD was associated with poor survival. Recovery of renal function was not associated with improved survival.
(© 2022. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.)