Clinical Research About Risk Factors And Reversible Factors In Renal Impairment Due To Multiple Myeloma

OBJEKTIVE Clinical records of multiple myeloma (MM) patients accompanied with renal impairment were studied retrospectively, so as to explore the risk factors of renal impairment, the predictive factors of renal function recovery and provide basis for its prevention and treatment.METHODS Medical records of161patients with MM first diagnosed from January2007to April2013were reviewed. Among them58were accompanied with renal insufficiency (group A) and39of them regain normal renal function after some treatment,103were regarded as without renal involvement (group B). We analysed the possible related renal impairment risk factors and reversible predictors with chi-square test for significance firstly, then factors that have significant difference entered into multifactorial Logistic-regression analysis.RESULTS Systolic pressure, hemoglobin, uric acid, blood calcium, phosphorus, serum beta2-microglobulin, urine beta2-microglobulin, immune globulin classification, the type of light chain, renal toxicity of drug use, infection, in group A compared with those in group B had significant difference (P＜0.05), and systolic pressure, diastolic pressure, platelet, globulin, Ca, urine beta2-microglobulin, the chemotherapy and the response to chemotherapy in reversed group compared with no reverse group had significant difference (P＜0.05).Multifactorial logistic regression showed that the type of light chain, Hb, Uric, Ca were the independent risk factors for the development of renal failure in MM, and Ca, chemotherapy and the response to chemotherapy were the predictors of renal function recovery.CONCLUSIONS Renal impairment is one of the common complications of patients with MM. λ light chain, severe anemia, high uric acid, blood calcium are the independent risk factors of renal impairment in MM patients. Patients with high blood calcium before treatment would easily regain normal renal function after effective chemotherapy. Bortezomib-based chemotherapy had higher response rate and higher reversal rate maybe related to its unique mechanism.