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Kidney and multiple myeloma: Prevalence, risk factors and prognosis

Dr. Imane Failal

Introduction

Multiple myeloma (MM) is a blood disorder characterized by a malignant monoclonal proliferation of plasma cells. It represents 10% of hematological malignancies. And 50% of patients with renal impairment.Renal involvement in multiple myeloma is common, it complicates the management of patients and often worsens the prognosis.

The objective of this study was to describe the epidemiological, clinical, biological, histological, treatment and outcome of renal damage in the MM, identify predictors of poor renal response in the MM and mortality of patients MM with renal impairment.

Patients methods:

This is a retrospective study, spread over 7 years from January 2012 to September 2017.incluant all patients with MM with renal impairment, supported the Nephrology Hospital IBN ROCHD Casablanca

Results

We collected 53 cases of MM with renal impairment, the mean age was 57.14 years, with extremes ranging from 21 years to 67 years, a male of 60%. The average time between consultation and diagnosis was 2 months. Renal involvement was opening in 80% of cases. Clinical manifestations were dominated by impaired general condition (AEG) in 33% of cases, and the anemic syndrome in 90% of cases.Renal biopsy was performed in 25 patients, revealing a myeloma tubulopathy in 30% of cases, amyloidosis in 40% of patients, a disease of the deposits of monoclonal immunoglobulin chains in 25%.The causes of death were dominated by infectious complications.The factors of poor renal response were male sex, hemorrhagic syndrome the development of kidney disease as a first telltale sign of myeloma, the presence of renal failure at admission with high numbers of plasma creatinine

Discussion

Renal involvement in the MM takes many forms, and renal prognosis depends mainly on hematologic response and the severity of the initial kidney damage. The results of our study confirm the poor prognosis of these patients.