Nephrology Division, Federal University of Sao Paulo, Universidade Federal de São Paulo (UNIFESP), Botucatu street - cj. 153, n° 591, 15th floor - Vila Clementino, Sao Paulo, 04023-062, SP, Brazil.
Clinical and Experimental Oncology Department, Federal University of Sao Paulo, Sao Paulo, Brazil.
BMC Nephrol. 2024 Oct 11;25(1):344. doi: 10.1186/s12882-024-03717-5.
Kidney disease is a common complication of multiple myeloma (MM) and a risk factor for increased morbimortality. In this retrospective cohort study based on medical records, we analyzed the kidney function of patients with renal disease related to MM during the first year of treatment. All patients included were consecutively admitted to the outpatient services of two hospitals between January 2009 and January 2019 and met the diagnostic criteria for MM regardless of the reason for seeking medical help. We excluded patients who had kidney disease or who were on dialysis before MM diagnosis. We investigated the factors associated with renal function recovery using multivariate analysis. We evaluated 167 patients (median age of 66 ± 11.49 years). Almost half of the patients had arterial hypertension (76; 45.5%). The majority had International Staging System (ISS) grades 3 (73; 43.7%) or 2 (60; 35.9%). Seventy-four (44%) patients had an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m² at the time of MM diagnosis. Fifty-two patients (31%) underwent hematopoietic stem cell transplantation (HSCT). After 12 months, 4 (2.3%) patients needed dialysis, and 18 (10.7%) died. The factors associated with an eGFR < 60 ml/min/1.73 m² were anemia, hyperuricemia, 24-hour proteinuria > 1.0 g, and extramedullary plasmacytoma. However, only baseline renal function (eGFR > 60 ml/min/1.73 m) and HSCT were associated with greater recovery of renal function at 12 months of follow-up.
肾脏疾病是多发性骨髓瘤（MM）的常见并发症，也是增加发病率和死亡率的一个风险因素。在这项基于病历的回顾性队列研究中，我们分析了在治疗的第一年中与 MM 相关的肾脏疾病患者的肾功能。所有纳入的患者均连续于 2009 年 1 月至 2019 年 1 月期间在两家医院的门诊就诊，无论寻求医疗帮助的原因如何，均符合 MM 的诊断标准。我们排除了在 MM 诊断前患有肾脏疾病或正在接受透析的患者。我们使用多变量分析研究了与肾功能恢复相关的因素。我们评估了 167 名患者（中位年龄 66±11.49 岁）。近一半的患者有动脉高血压（76 例；45.5%）。大多数患者具有国际分期系统（ISS）分级 3（73 例；43.7%）或 2（60 例；35.9%）。74 例（44%）患者在 MM 诊断时肾小球滤过率（eGFR）<60ml/min/1.73m²。52 例（31%）患者接受了造血干细胞移植（HSCT）。12 个月后，有 4 例（2.3%）患者需要透析，18 例（10.7%）患者死亡。与 eGFR<60ml/min/1.73m²相关的因素有贫血、高尿酸血症、24 小时蛋白尿>1.0g 和髓外浆细胞瘤。然而，只有基线肾功能（eGFR>60ml/min/1.73m）和 HSCT 与 12 个月随访时肾功能的更大恢复相关。
