| Risk Factors and Reversibility of Renal Failure in Patients with Newly Diagnosed
Multiple Myeloma |
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Hyun Chul Whang, Eun Sil Koh, Jeong Gwan Kim, Sungjin Chung, Seok Joon Shin, Cheol Whee Park, Yoon Sik Chang |
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Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea |
| 다발성 골수종에서 신부전 발생의 위험인자 및 신기능 회복
예측인자 |
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황현철, 고은실, 김정관, 정성진, 신석준, 박철휘, 장윤식 |
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가톨릭대학교 의과대학 내과학교실 신장내과 |
Correspondence:
Yoon Sik Chang, Tel: +82-2-3779-1259, Fax: +82-2-780-3132, Email: ysc543@unitel.co.kr
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Received: 14 May 2013 • Revised: 27 May 2013 • Accepted: 31 May 2013 |
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| This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits
unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
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| Abstract |
Background/Aims
Multiple myeloma (MM) is frequently accompanied by renal insufficiency, which has been regarded as a poor prognostic factor for MM. It is known that the incidence and characteristics of MM in Asia differ from those in Western countries. The aim of this study was to evaluate risk factors for renal impairment and to investigate reversible factors for renal failure in patients with MM.
Methods
Patients newly diagnosed with MM from 2005 to 2008 were included. We investigated factors associated with renal insufficiency and those related to recovery from renal dysfunction after 12 weeks of treatment of MM.
Results
Renal failure was recognized in 86 (39%) of 221 patients at diagnosis. In the binary logistic regression analysis, low hemoglobin (odds ratio [OR], 0.813; p = 0.02), high β2microglobulin (OR, 1.006; p < 0.01), and use of angiotensin-converting enzyme inhibitors (ACEi) (OR, 2.783; p < 0.04) at initial presentation were independent risk factors for renal failure in patients with multiple myeloma. After 12 weeks of treatment, 25 of 86 (29%) patients with renal failure had recovered renal function. Good response to chemotherapy (OR, 6.044; p < 0.01) and higher eGFR (OR, 1.084; p < 0.01) were associated with renal function recovery.
Conclusions
Levels of hemoglobin and β2microglobulin, and use of ACEi were independent risk factors for the development of renal failure in MM patients. The response to chemotherapy and eGFR at diagnosis significantly influenced recovery of renal function. (Korean J Med 2014;86:190-197) |
| Key Words:
Multiple myeloma; Renal insufficiency; Risk factors |
| 주제어:
다발성 골수종; 신부전; 위험인자 |
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