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Renal recovery after acute kidney injury requiring urgent hemodialysis is not associated with improved survival of the patients with multiple myeloma

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Abstract

Background

Severe acute kidney injury (AKI) requiring urgent hemodialysis (uHD) is associated with considerable morbidity and mortality in patients with multiple myeloma (MM).

Purpose

To evaluate the renal function, outcome, and survival status of patients with MM who received uHD and to compare their overall survival with MM patients who did not receive uHD.

Materials and methods

A total of 70 eligible MM patients who received uHD were included together with 70 control patients with MM.

Results

In the study group, 11 patients (15.7%) were known to have pre-existing chronic kidney disease. Thirty-four percent of the study group had AKI requiring uHD at MM diagnosis. Seventy-eight percent of the study group had severe AKI due to myeloma kidney. Renal function recovered in 36 patients (51.4%). Patients with MM who became hemodialysis dependent had significantly higher serum creatinine (sCr) levels at the time of AKI compared to patients with renal recovery (p < 0.05). Logistic regression analysis showed that high sCr on admission was significantly associated with hemodialysis dependence (odds ratio 0.78; 95% CI: 0.63–0.96; p = 0.018). The median overall survival was 30 months [IQR: 26] in the study group and 84 months [IQR: 96.25] in the control group (p < 0.05). Cox regression analysis showed that the need for uHD at initial MM diagnosis was associated with reduced survival (hazard ratio (HR) 1.9; 95% CI: 1.1–3.2; p = 0.017). Renal recovery did not provide a survival benefit.

Conclusion

The need for uHD was associated with poor survival. Recovery of renal function was not associated with improved survival.

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Author information

Authors and Affiliations

  1. Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Cerrahpaşa Medical School, Istanbul University-Cerrahpaşa, Kocamustafapasa Street No: 53, 34098, Fatih, Istanbul, Turkey

    Cem Sulu

  2. Division of Nephrology, Department of Internal Medicine, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul, Turkey

    Serkan Feyyaz Yalın

  3. Department of Internal Medicine, Cerrahpaşa Medical School, Istanbul University-Cerrahpaşa, Istanbul, Turkey

    Turgut Gürer

  4. Division of Hematology, Department of Internal Medicine, Cerrahpaşa Medical School, Istanbul University-Cerrahpaşa, Istanbul, Turkey

    Muhlis Cem Ar

  5. Division of Nephrology, Department of Internal Medicine, Cerrahpaşa Medical School, Istanbul University-Cerrahpaşa, Istanbul, Turkey

    Mehmet Rıza Altıparmak

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  1. Cem Sulu
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  2. Serkan Feyyaz Yalın
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  3. Turgut Gürer
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  5. Mehmet Rıza Altıparmak
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Contributions

Data were collected by Cem Sulu and Turgut Gürer. Writing assistance, tables, and statistical analysis was provided by Cem Sulu. Serkan Feyyaz Yalın, Muhlis Cem Ar, and Mehmet Rıza Altıparmak made substantial contributions to conception and design and/or analysis and interpretation of data, participated in drafting the article or revising it critically for important intellectual content, and gave final approval of the version to be submitted.

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Correspondence to Cem Sulu.

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All procedures performed in studies involving human participants were in accordance with ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Sulu, C., Yalın, S.F., Gürer, T. et al. Renal recovery after acute kidney injury requiring urgent hemodialysis is not associated with improved survival of the patients with multiple myeloma. Ir J Med Sci 192, 757–763 (2023). https://doi.org/10.1007/s11845-022-03014-w

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  • DOI: https://doi.org/10.1007/s11845-022-03014-w

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