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Časopis Internal medicine – Článok Severe acute kidney injury induced by multiple myeloma in 2-year follow-up study

Internal medicine

Peer - Reviewed Postgraduate Medical Journal.
Period 11x per year (july - august double issue)
1335-8359
The journal is indexed in the Slovak National Bibliography, Bibliographiia Medica Slovaca (BMS) and listed to citation database CiBaMed. All articles are reviewed. The publisher does not bear any responsibility for data and opinions of particular authors of the articles or advertisements. The articles on grey pages are company promotions or non reviewed information, an author is responsible for the content. Any reproduction of the content is allowed only with direct consent of the editorial office.
Predplatné
Internal medicine
Internal medicine
Peer - Reviewed Postgraduate Medical Journal.
Period 11x per year (july - august double issue)
Predplatné
Téma: Original works

Severe acute kidney injury induced by multiple myeloma in 2-year follow-up study

Jana Mateovičová, Peter Ponťuch, Zdenka Štefániková, Katarína Masárová, Miroslav Budaj, Martin Mistrík

Aim: To analyse retrospectively clinical condition and laboratory changes in patients with multiple myeloma (MM) and severe acute kidney injury (AKI).
Patients and methods: From 351 patients registered with MM in specialized out-patient clinic in years 2007-2015 we selected 32 patients aged 66 (51-83; median, range) years with serum creatinine increased above 2 mg/dl (177 μmol/l) according to CRAB (C-hypercalcemia, R-renal dysfunction, A-anemia, B-bone disorder) criteria. Diagnostics of MM: serum ß2-microglobulin (ß2-MG), serum monoclonal immunoglobulin (mIg), serum free light chains κ, λ (FLC) a cytogenetic examination of bone marrow.
Results: After one year of MM treatment, we found significant decreases in serum concentration of ß2-MG from 11,2 (6,9-26,6; median, IQR) to 4,0 (3,1-9,4) mg/l, mIg from 13 (3,6-31,2) g/l to 1,7 (0-4,5) g/l and FLC κ, λ from 1539 (342-9070) to 41,7 (16-306) mg/l and bone marrow infiltration by plasmocytes from 33 (23,5-54,9) % to 1,2 (0,32‑4,9) % (all differences p < 0,001). During AKI at a baseline, serum creatinine reached 283 (210-469) μmol/l and estimated glomerular filtration rate (eGFR) 0,3 (0,17-0,46) ml/s/1,73 m2. After one year of MM treatment, serum creatinine significantly decreased to 125 (95-188) μmol/l and eGFR increased to 0,8 (0,44-1,04) ml/s/1,73 m2(p < 0,001).After two years, serum creatinine increased to 165 (126-239) μmol/l and eGFR decreased to 0, 62 (0,39-0,81) ml/s/1,73 m2. We have not found any significant partial correlation between bone marrow infiltration by plasmocytes and serum creatinine, or ß2-MG. There was only one significant partial correlation between serum creatinine and serum ß2-MG (p < 0,001). Eleven patients were treated by acute haemodialysis. A mean survival of patients on acute haemodialysis was 22 months, while of those without haemodialysis 69 months. During two-year period 13 (41%) patients died.
Conclusion: From among all patients with MM, a course of the disease was complicated by severe AKI in 32 (9,1 %) patients, 11 patients from them were on acute haemodialysis.After one year of MM treatment, we found significant decreases in serum concentration of ß2-MG, mIg, FLC κ, λ and bone marrow infiltration with plasmocytes. Concurrently after one year, serum creatinine significantly decreased and eGFR increased. After two years, mild increase in serum creatinine and decrease in eGFR were found.

acute kidney injury, multiple myeloma
Interná med. 2018; 18 (3): 117-121

Ročník 2018  Témy časopisu Internal medicine 3 / 2018

Overview works

Viera Fábryová
Denisa Čelovská, Viera Štvrtinová, Miroslav Malík, Dáša Mesárošová, Silvia Strečanská, Marína Arpášová, Soňa Kiňová
Zora Lazúrová, Peter Mitro
Iveta Ondriová, Terézia Fertaľová, Lívia Hadašová
Andrej Dukát, Eliška Kubíková, Milan Kriška, Martin Kužma, Peter Gavorník, Juraj Payer

Original works

Jana Mateovičová, Peter Ponťuch, Zdenka Štefániková, Katarína Masárová, Miroslav Budaj, Martin Mistrík
Emil Martinka, Jana Varsová
Nie sú dostupné žiadne voľne dostupné články
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Period 11x per year (july - august double issue)
1335-8359
The journal is indexed in the Slovak National Bibliography, Bibliographiia Medica Slovaca (BMS) and listed to citation database CiBaMed. All articles are reviewed. The publisher does not bear any responsibility for data and opinions of particular authors of the articles or advertisements. The articles on grey pages are company promotions or non reviewed information, an author is responsible for the content. Any reproduction of the content is allowed only with direct consent of the editorial office.
Predplatné
Internal medicine
Internal medicine
Peer - Reviewed Postgraduate Medical Journal.
Period 11x per year (july - august double issue)
Predplatné