Acute kidney injury on chronic kidney disease: from congestive heart failure to light chain deposition disease and cast nephropathy in multiple myeloma

Shaikh, Sana; Nwankwo, Christian; Lacasse, Alexandre; Cheng, Steven

doi:10.1080/20009666.2019.1624136

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…Patients with MM may exhibit various forms of kidney injury, such as cast nephropathy and monoclonal immunoglobulin renal deposition disease. Cast nephropathy is the most frequently observed pattern in myeloma patients with renal involvement [ 19 ]. This condition is primarily characterized by the formation of clear cylinders and proximal tubular damage, which are caused by free light chains in the urine [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Kidney Transplantation and Clinical Outcomes in Patients With Multiple Myeloma: Evidence From the United States Nationwide Inpatient Sample

Yang,

Zhang,

2023

Int Neurourol J

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Purpose: Patients with multiple myeloma (MM) are prone to developing persistent renal insufficiency. Novel therapeutic medications have improved long-term survival, making kidney transplantation (KT) a viable treatment option for MM survivors with end-stage renal disease. This study aimed to investigate the clinical outcomes in patients with MM who have received KT.Methods: Data from hospitalized patients ≥ 40 years of age with MM in the Nationwide Inpatient Sample 2016–2018 of the United States were queried. Patients were classified as having or not having undergone KT, as well as the stage of chronic kidney disease (CKD) for those who had not received KT. Propensity-score matching (PSM) was applied to balance the characteristics between the groups. Binary logistic regression was utilized to determine the associations between study variables and inhospital mortality, unfavorable discharges, prolonged length of stay (LOS), and major complications.Results: In total, 50,654 hospitalized patients with MM were identified, of whom 165 (0.3%) had received KT and 50,489 had not (5,905 at stage 5 CKD [CKD5D], 11,559 at stage 1–4 CKD [CKD1-4D], and 33,025 who were CKD-free). After PSM, between-group demographic and hospital-related characteristics were balanced. Binary regression analysis revealed that, compared to patients who were CKD-free, patients at CKD5D were significantly more likely to experience a prolonged LOS (odds ratio [OR], 1.31; 95% confidence interval [CI], 1.01–1.70) after adjusting for relevant confounders. Furthermore, compared to CKD-free patients, those who underwent KT were significantly more likely to have sepsis (OR, 1.48; 95% CI, 1.02–2.14). However, KT showed no association with the other adverse inpatient outcomes.Conclusions: Although KT is not common in MM patients, those who had undergone KT had comparable hospital outcomes to CKD-free patients. These data will help clinicians deliver better consultations to MM patients attempting to receive KT.

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Section: Discussionmentioning

confidence: 99%

Kidney Transplantation and Clinical Outcomes in Patients With Multiple Myeloma: Evidence From the United States Nationwide Inpatient Sample

Yang,

Zhang,

2023

Int Neurourol J

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“…Multiple pathogenetic mechanisms may contribute to renal dysfunction in MM patients, but the most studied are those induced by the nephrotoxicity of monoclonal Ig and/or its components. [15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

The difference of free light chains as a predictor of kidney damage in patients with Multiple Myeloma

Mancuso¹,

Carlisi²,

Serra

et al. 2022

ebph

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Background: Multiple myeloma (MM) is a malignant neoplasm characterized by the clonal expansion of plasma cells that can release monoclonal immunoglobulins (monoclonal component) or part of theme. Since 2001, the k and λ serum free light chains (sFLC) evaluation and their ratio (rFLC) have made up the laboratory analysis more sensitive and precise in MM patients. The role of rFLC has been widely studied and discussed and now it is validated in the literature. Instead, the value of free light chains difference (dFLC), especially in MM is less known yet. The aim of this study is to evaluate the relationship between the dFLC and the kidney damage parameters in patients with MM, in comparison with the rFLC value. Methods: We conducted a retrospective population-based study on 58 MM patients and we individuated two groups obtained considering the measures of dFLC and rFLC in relation to abnormal and normal values of some renal function markers, such us Bence-Jones proteinuria (BJ), albuminuria, proteinuria and serum creatinine. The Mann-Whitney test was used to test the difference between two independent samples. Results: We observed a significant greater mean score of dFLC in patients with abnormal levels of BJ (2322.91>297.47, p=0.0001), albuminuria (2650.61>671.37, p=0.0016) and proteinuria (2327.19>593.14, p= 0.0025), while there was no significant difference for serum creatinine (1636.18<1870.85, p=0.994). Instead, no differences were observed for the rFLC parameter. Conclusion: The data obtained allow us to conclude that dFLC can be considered a potential predictor of renal damage in MM patients, even better than rFLC.

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Acute kidney injury on chronic kidney disease: from congestive heart failure to light chain deposition disease and cast nephropathy in multiple myeloma

Cited by 2 publications

References 12 publications

Kidney Transplantation and Clinical Outcomes in Patients With Multiple Myeloma: Evidence From the United States Nationwide Inpatient Sample

Kidney Transplantation and Clinical Outcomes in Patients With Multiple Myeloma: Evidence From the United States Nationwide Inpatient Sample

The difference of free light chains as a predictor of kidney damage in patients with Multiple Myeloma

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