Clinical Characteristics And Risk Factors Analysis Of Multiple Myeloma Patients With Renal Impairment

Objective:To study the clinical characteristics and risk factors of Muitiple Myeloma patients with renal impairment.Methods:A retrospective analysis was performed on 224 initially diagnosed multiple myeloma patients admitted to the second hospital of shanxi medical university from September 2014 to September 2019.According to creatinine > 176.8umol/L,all patients were divided into the MM with renal impairment group and MM with normal renal function group.One-way analysis of variance was used for the comparison of measurement data.chi-square test was used for comparison of enumeration data.The independent risk factors for multiple myeloma with renal insufficiency were analyzed by binary Logistic regression.Results:Among the 224 patients,94 were renal impairment,of which the male accounted for 69.1%,the ratio of male to female was 2.3:1.The age in the MM with renal insufficiency group was(63±9)years old,while that in the MM with normal renal function group was(57±9)years old,the difference was statistically significant(P<0.05).There were 79 patients(84%)with ISS stage III in the MM with renal insufficiency group,and 62 patients(47.7%)with ISS stage III in the MM with normal renal function group,the difference was statistically significant(P<0.05).The incidence of proteinuria in the MM with renal insufficiency group was 45.6%,andthat in the MM with normal renal function group was 20.7%,the difference was statistically significant(P<0.05).Compared with the MM patients with normal renal function group,there were statistically significant differences in age,blood calcium,blood phosphorus,serum uric acid,?2-microglobulin,hemoglobin,Urine?2-microglobulin,urinary microalbumin levels in the MM patients with renal insufficiency group(P<0.05).The results of FISH gene detection showed that RB1 gene deletion accounted for 23.8%,1q21 gene amplification accounted for 30.9%,P53 gene deletion accounted for 7.1%,D13S319 gene deletion accounted for 26.2%,and IGH gene rearrangement accounted for 30.9% in the MM with renal insufficiency group.The results of serum immunoglobulin assay results showed that light chain type accounted for 45.7%,IgA type accounted for 12.7%,IgG type accounted for 34%,IgD type accounted for 5.3%,double clone type(IgG and IgA)accounted for1.1%,non-secreted type accounted for 1.1% in the MM patients with renal impairment.The proportion of light chain type patients in the MM patients with renal insufficiency group was 45.7%,while the proportion of light chain type patients in the MM patients with normal renal function group was 15.4%,the difference was statistically significant(P<0.05).Logistic regression suggested that the independent risk factors of renal impairment were anemia,hypercalcemia,and Light chain of MM.Conclusions:Renal impairment in newly diagnosed multiple myeloma patients is common in clinical practice.ISS stage III patients are the most common in multiple myeloma patients with renal impairment,and light chain type is the most common in immune typing.Logistic regression suggested that the independent risk factors of renal impairment were anemia,hypercalcemia,and Light chain of MM.