Kidney Injury in Multiple Myeloma: A Kidney Biopsy Teaching Case

Owoyemi, Itunu; Sethi, Sanjeev; Leung, Nelson

doi:10.1016/j.xkme.2020.10.013

Cited by 5 publications

(7 citation statements)

References 16 publications

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“…15 Patients with IgG type myeloma are prone to a decline in organism immunity, leading to infection and aggravating the disease progression, those with IgA-type are susceptible to hypercalcemia and hypercholesterolemia, while those with IgM and light chain type are prone to renal dysfunction. [16][17][18] It may therefore be of definite value to predict the prognosis of HSCT in patients with multiple myeloma based on the IG type of patients.…”

Section: Discussionmentioning

confidence: 99%

Application of urine immunofixation electrophoresis in prognostic evaluation of hematopoietic stem cell transplantation in patients with myeloma

Zhu¹,

Yang²,

et al. 2021

Pak J Med Sci

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Objectives: To investigate the value of urine immunofixation electrophoresis in prognostic evaluation of hematopoietic stem cell transplantation in patients with myeloma. Methods: Thirty-four patients with multiple myeloma admitted to Affiliated Hospital of Hebei University from November 2013 to December 2014 were included as research subjects. All patients received hematopoietic stem cell transplantation and were followed up for five years. Outcomes were evaluated according to the recovery status: complete response (CR), very good partial response (VGPR), partial response (PR), stable disease (SD), and progression disease (PD). In addition, the overall response rate (CR+VGPR) of patients was observed and their urine immunoglobulin status was measured by immunofixation electrophoresis. The Kaplan-Meier method was utilized to plot the survival curve, and the Log-rank method was adopted to analyze the relationship between CR+VGPR and PR and hematopoietic stem cell transplantation (HSCT) survival in patients with myeloma. Results: The basic clinical type of immunofixation electrophoresis was as follows: 19 cases (55.88%) of IgG, 7 cases (20.59%) of IgA, 6 cases (17.65%) of IgM, and 2 cases (5.88%) of light chain type. Outcomes: 13 cases (38.24%) of CR, 12 cases (35.29%) of VGPR, 9 cases (26.47%) of PR, and 25 cases (73.53%) of the overall response rate (CR+VGPR). Compared with IgG, CR, VGPR and PR of IgA, IgM and light chain had statistically significant differences in outcome (p<0.05), and CR+VGPR of patients with IgG was higher than that of patients with IgA, IgM and light chain type (p<0.05). Two of the 34 patients were lost to follow-up. The log-rank analysis showed that the survival rate of patients with CR+VGPR was higher than that of patients with PR (p<0.05). Patients with IgA, IgM, and light chain type had an increased number of prognostic death compared with those with IgG (p<0.05). Conclusion: Patients with IgG type myeloma are superior to those with IgA, IgM and light chain type in terms of the prognosis of hematopoietic stem cell transplantation, which has a certain clinical reference value. doi: https://doi.org/10.12669/pjms.38.1.4425 How to cite this:Zhu S, Yang C, Li W, Lin M. Application of urine immunofixation electrophoresis in prognostic evaluation of hematopoietic stem cell transplantation in patients with myeloma. Pak J Med Sci. 2022;38(1):315-319. doi: https://doi.org/10.12669/pjms.38.1.4425 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionmentioning

confidence: 99%

Application of urine immunofixation electrophoresis in prognostic evaluation of hematopoietic stem cell transplantation in patients with myeloma

Zhu¹,

Yang²,

et al. 2021

Pak J Med Sci

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“…Table 1 summarizes the clinical presentation, treatment and outcomes in 20 patients, including ours. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Mean age at diagnosis was 56 years (range, 34 to 82). Patients presented with mean serum creatinine level of 6.7 mg/dL (590 µmol/l), and dialysis was required in 16 (80%).…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

Crystalglobulin-Associated Kidney Disease: A Case Report and Literature Review

et al. 2022

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“…7 At the time of diagnosis, almost 50% of the myeloma cases have significantly decreased kidney function (estimated glomerular filtration rate less than 60 mL/minute/1.73m 2 ), with 10 to 15% needing hemodialysis and approximately 1% progressing to end-stage kidney disease. 8,9 A Pakistani research also shows 35% of the myeloma patients had renal impairment (serum creatinine>2 mg/dl) at the time of diagnosis. 5 Studies by Mok et al revealed that chronic kidney disease is positively associated with mortality among myeloma patients.…”

Section: Introductionmentioning

confidence: 99%

“…10,11 Literature has also revealed that improved survival of myeloma patients is linked with reversibility of renal dysfunction. 1,8,10,12 Treatment of myeloma with kidney disease includes removing aggravating factors of renal impairment, drinking enough water, alkalinizing urine, and preventing hypercalcemia as well as hyperuricemia. Dialysis is suitable for myeloma patients with severe renal function.…”

Section: Introductionmentioning

confidence: 99%

“…Dialysis is suitable for myeloma patients with severe renal function. 1,8,10,12 Even after the advancement in therapeutic agents and supportive care, still the precise mechanisms for the development of myelomas in patients with kidney disease are incompletely understood. In Pakistan, limited data is available regarding the burden of myeloma in chronic kidney disease patients.…”

Section: Introductionmentioning

confidence: 99%

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Association of Myeloma in Patients of Chronic Kidney Disease; A Single Centered Study

Sheikh,

Ali,

Rashid

et al. 2023

J. Bahria Uni. Med. Dent. Coll.

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Objective: To evaluate the frequency along with socio-demographic factors and clinical features of myeloma in patients with chronic kidney disease (CKD) presenting at a tertiary care hospital in Karachi, Pakistan. Study design and setting: It was a cross-sectional study conducted at the Department of Nephrology and Hematology, Liaquat National Hospital, Karachi, Pakistan from Jan 2022 to Jul 2022. Methodology: Patients of age>18 years of either gender having chronic kidney disease were included in the study. Detailed data regarding socio-demographic factors, clinical features and presence of multiple myeloma was obtained. Myeloma was diagnosed in the patients using WHO criteria i.e. presence of M-protein in urine or serum, presence of clonal plasma cells in bone marrow, and related tissue or organ failure. Data was entered and analyzed using SPSS version 25. Results: The median age of the patients with chronic kidney disease was 54 years and most of them were males (63%). Myeloma was detected in only 14 patients with CKD. The proportion of myeloma was similar across chronic kidney disease stages, and statistically there was no significant association between chronic kidney disease stages and myeloma with pvalue=0.08. There were no differences in hemoglobin, serum calcium, serum albumin, serum total protein, albumin/globulin (A/G) ratio, ESR, comorbid in patients with and without myeloma (p>0.05). Conclusion: The frequency of myeloma among patients with chronic kidney disease was low.

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Kidney Injury in Multiple Myeloma: A Kidney Biopsy Teaching Case

Cited by 5 publications

References 16 publications

Application of urine immunofixation electrophoresis in prognostic evaluation of hematopoietic stem cell transplantation in patients with myeloma

Application of urine immunofixation electrophoresis in prognostic evaluation of hematopoietic stem cell transplantation in patients with myeloma

Crystalglobulin-Associated Kidney Disease: A Case Report and Literature Review

Association of Myeloma in Patients of Chronic Kidney Disease; A Single Centered Study

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