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      Myeloma Renal Disease: Presentation and Outcome


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          Background: Renal disease can be the first presentation of multiple myeloma (MM) or develop during the disease process. Aim: To define the mode of presentation of MM to nephrologists and determine the association with patient characteristics and outcome. Methods: MM patients referred to a tertiary renal unit were studied retrospectively. Group I presented to nephrologists prior to MM diagnosis (n = 36); group II was referred to nephrology after diagnosis (n = 27), and group III was known only to haematology and never referred (n = 91). Age at presentation, gender, paraprotein type, need for dialysis, haematological and biochemical parameters, and survival were examined. Results: Of the 154 MM patients, 23.4% presented with renal impairment (group I), 17.5% were referred to nephrology after MM diagnosis (group II) and 59.1% did not receive renal input (group III). On presentation, group I had a median serum creatinine (sCr) of 700 (range 341–1,023) µmol/l and 80% required dialysis. Although the median sCr on presentation for group II was 131 (range 103–373) µmol/l, median sCr on renal referral was 554 (range 181–807) µmol/l and 57% needed dialysis. In contrast, the median sCr on presentation for group III was only 99 (range 85–117) µmol/l. Group I was more anaemic (p < 0.001) and had higher β<sub>2</sub>-microglobulin levels (p < 0.0001) on presentation compared to groups II and III. For groups I and II, the median survival after diagnosis (10.2 vs. 24.7 months, p = 0.11) and renal referral (10.5 vs. 20.0 months, p = 0.68) was not significantly different. Conclusion: Survival in myeloma renal disease remains poor regardless of the mode of presentation to nephrologists.

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          Renal Failure in Multiple Myeloma


            Author and article information

            Nephron Clin Pract
            Nephron Clinical Practice
            S. Karger AG
            October 2006
            14 July 2006
            : 104
            : 3
            : c126-c131
            aDepartment of Nephrology and Transplantation, University Hospital of Wales, Cardiff, UK;
            94545 Nephron Clin Pract 2006;104:c126–c131
            © 2006 S. Karger AG, Basel

            Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

            : 31 August 2005
            : 23 April 2006
            Page count
            Figures: 3, Tables: 3, References: 6, Pages: 1
            Self URI (application/pdf): https://www.karger.com/Article/Pdf/94545
            Self URI (text/html): https://www.karger.com/Article/FullText/94545
            Self URI (journal page): https://www.karger.com/SubjectArea/Nephrology
            Original Paper

            Cardiovascular Medicine,Nephrology
            Serum creatinine,Multiple myeloma, presentation,Paraprotein,Haemoglobin,Renal impairment


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