Clinical Features of Renal Insufficiency due to Multiple Myeloma and Related Risk Factors

Abstract

Objective: To study clinical features of the patients with multiple myeloma (MM) accompanied by renal insufficiency and investigate the related risk factors of renal impairment. Methods: A control study of clinical characteristics was performed between 91 patients with renal insufficiency due to MM and 165 patients with normal renal function in MM during the same period. The data were statistically analyzed by chi-square test and logistic regression analysis. Results: Renal insufficiency was the initial presentation in 48 (52.7%) of the 91 patients, and 30 (62.5%) of the 48 patients were misdiagnosed. The prognosis of group with renal insufficiency was significantly poorer than that of group with normal renal function: mortality in 3 months, 3 months-1 year was 26/91 vs 14/165 (P <0.0001), 14/91 vs 12/165 (P <0.05) respectively, and patients survived ≥1 year was 18/91 vs 95/165 (P <0.0001). The incidence of hypercalcemia, hyperuricemic, severe anemia, high serum M-protein concentration and lytic bone lesions were significantly higher in renal insufficiency group than those in control group (P <0.05). Logistic regression analysis identified 5 risk factors of renal impairment, including, severe anemia (Exp(β)=13.819, P <0.0001), use of nephrotoxic drugs (Exp(β)=6.217, P =0.001), high serum M-protein concentration (Exp(β)=5.026, P =0.001), male (Exp(β)=3.745, P =0.006), and hypercalcemia (Exp(β)=3.472, P =0.006), but age, serum density of uric acid, type of serum M-protein, and Bence Jones proteinuria were not significantly associated with renal insufficiency. Conclusion: Renal insufficiency was a common early complication of MM, which often resulted in misdiagnosis. The status of these patients tended to be very bad, with many other complications, when MM was diagnosed, so their prognosis was poor. The occurrence of renal insufficiency in patients with MM and hypercalcemia, severe anemia, high serum M-protein concentration, especially use of nephrotoxic drugs should be alert.Multiple myeloma (MM) is a malignant disease characterized by uncontrolled growth of plasma cells in the bone marrow. Renal insufficiency is a common complication of MM, which is not only one of the reasons resulting in misdiagnosis of MM but also impacts the prognosis of patients with MM. There have been some reports on clinical features, incidence, therapy and outcome of patients with MM and renal insufficiency, but the results were variable. Moreover, the reports about risk factors associated with renal insufficiency of MM are few. So it is necessary to study the clinical features and factors related to renal insufficiency in these patients. The following is a retrospective analysis of 91 patients with MM and renal insufficiency.

Risk factors of central catheter bloodstream infections in intensive care units: A systematic review and meta-analysis

“…Our pooled results showed that patients with tube indwelling more than one time have a 3.50-fold risk of getting CRBSI compared to patients with tube indwelling one time. On the one thing, some studies [ 45 ] consider that if the tube indwelling is difficult, the same number of pastes is over 2 times, the opportunity of the infection would be increases. On another things, blindness, repeated puncture route could be largely damage to local subcutaneous tissue and intravascular inner wall, to increase the possibility of inflammatory reactions and catheter infections, which could lead to CRBSI.…”