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持续静脉-静脉血液滤过联合血液灌流治疗多发性骨髓瘤合并急性肾损伤的临床疗效

Clinical effects of continuous veno-venous hemofiltration combined with hemoperfusion for the treatment of multiple myeloma complicated with acute kidney injury.

作者信息

Huang Jing, Qiu Fengping, Zhang Huiqi, Shen Xiangli, Lin Xia

机构信息

Jing Huang, Department of Hematology, The First People's Hospital of Huzhou, Zhejiang Province, Huzhou 313000, Zhejiang Province, P.R. China.

Fengping Qiu, Department of Nephrology, The First People's Hospital of Huzhou, Zhejiang Province, Huzhou 313000, Zhejiang Province, P.R. China.

出版信息

Pak J Med Sci. 2023 Mar-Apr;39(2):344-348. doi: 10.12669/pjms.39.2.6966.

Abstract

OBJECTIVE

To evaluate the clinical efficacy of continuous veno-venous hemofiltration (CVVH) combined with hemoperfusion for the treatment of multiple myeloma (MM) complicated with acute kidney injury (AKI).

METHODS

Medical records of 73 patients with MM complicated with AKI admitted to the First People's Hospital of Huzhou from January 2019 to January 2021 were retrospectively analyzed. According to the treatment records, 35 patients received simple chemotherapy (control group), and 38 patients received CVVH combined with HP on the basis of chemotherapy (observation group). We compared the clinical efficacies, renal function indexes, and the serum globulin and erythrocyte sedimentation rate (ESR) values between the two groups.

RESULTS

After the treatment, the total efficacy of the observation group was significantly higher (81.58%) than that in the control group (57.14%; <0.05). Serum cystatin C (CysC), urea nitrogen (BUN), β macroglobulin (β-MG) and creatinine (SCr) levels were significantly lower in the observation group than in the control group ( <0.05). Serum globulin level and ESR values in the observation group after the treatment were also significantly lower than in the control group ( <0.05).

CONCLUSIONS

The outcomes of patients with MM complicated with AKI treated with CVVH and hemoperfusion differ significantly from those of the patients treated only with CVVH. Combining CVVH and hemoperfusion helps to improve the efficacy of the treatment, promotes renal function recovery, and improves the levels of serum globulin and ESR.

摘要

目的

评估持续静脉-静脉血液滤过(CVVH)联合血液灌流治疗多发性骨髓瘤(MM)合并急性肾损伤(AKI)的临床疗效。

方法

回顾性分析2019年1月至2021年1月湖州市第一人民医院收治的73例MM合并AKI患者的病历资料。根据治疗记录,35例患者接受单纯化疗(对照组),38例患者在化疗基础上接受CVVH联合血液灌流(观察组)。比较两组的临床疗效、肾功能指标以及血清球蛋白和红细胞沉降率(ESR)值。

结果

治疗后,观察组的总有效率(81.58%)显著高于对照组(57.14%;P<0.05)。观察组血清胱抑素C(CysC)、尿素氮(BUN)、β微球蛋白(β-MG)和肌酐(SCr)水平显著低于对照组(P<0.05)。治疗后观察组血清球蛋白水平和ESR值也显著低于对照组(P<0.05)。

结论

MM合并AKI患者采用CVVH和血液灌流治疗的效果与仅采用CVVH治疗的患者有显著差异。CVVH与血液灌流联合应用有助于提高治疗效果,促进肾功能恢复,并改善血清球蛋白水平和ESR。

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Management of acute kidney injury in symptomatic multiple myeloma.症状性多发性骨髓瘤急性肾损伤的治疗。
Kidney Int. 2021 Mar;99(3):570-580. doi: 10.1016/j.kint.2020.11.010. Epub 2021 Jan 10.

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