Abstract: FR-PO242
Impact of Race on Renal Recovery in Patients with New Diagnosis of Multiple Myeloma and AKI Requiring Dialysis
Session Information
- Onconephrology: From AKI to CKD and Everything in Between
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Onconephrology
- 1700 Onconephrology
Authors
- Kanduri, Swetha Rani, Ochsner Medical Center, New Orleans, Louisiana, United States
- Patel, Devang Bharat, Ochsner Medical Center, New Orleans, Louisiana, United States
- Somaiah, Prarthana, Ochsner Medical Center, New Orleans, Louisiana, United States
- Nombera, Natalia R., Ochsner Medical Center, New Orleans, Louisiana, United States
- Badari, Ambuga, Ochsner Medical Center, New Orleans, Louisiana, United States
- Velez, Juan Carlos Q., Ochsner Medical Center, New Orleans, Louisiana, United States
Background
Renal involvement is reported in about 20-50% of the patients with multiple myeloma. Although renal recovery is associated with improved survival, it is unclear whether a disparity exists among Black and White races with new diagnosis multiple myeloma (NDMM) and renal recovery. Additionally, factors associated with the probability of renal recovery are not clearly understood.
Methods
A retrospective review of medical records was conducted searching for cases of NDMM with acute kidney injury (AKI) needing renal replacement therapy (RRT) at Ochsner Medical Center over a 10-year period. Patients with relapses were excluded. We aimed to identify number of patients achieving RRT independence by race, mean time to renal recovery by race, and factors associated with RRT independence for the entire cohort.
Results
A total of 54 patients (27 Black and 27 White) were included. The mean age was 63 years, 63% males. Six (11%) had overt albuminuria. RRT independence was achieved in 9/27 (33%) Blacks and 6/27 (22%) Whites. Among those who recovered, 3/9 (33%) Blacks were alive at last follow-up compared to 5/6 (83%) Whites (p=0.06). The mean time to renal recovery was 33 vs. 22 days in Blacks and Whites respectively (p=0.48). The mean kappa value before RRT initiation was 310 mg/dL for those who recovered vs 1024 mg/dL for those who did not (p=0.015), whereas the mean lambda value was 383 mg/dL in those who recovered vs 755 mg/dL in those who did not (p=0.09). Other variables, serum creatinine (p=0.90), urine protein/creatinine (p=0.42), LDH (p=0.45) B2-microglobulin (p=0.48) were not different between groups. High risk cytogenetics {t(4:14), t(4:16), t(14,20), gain (1q21), del (1p), del (17p)} were reported in 3/15 (20%) in recovered vs 11/39 (28%) non-recovered (p=0.55)
Conclusion
A trend for better survival off RRT was observed in White patients with NDMM. However, limited number of patients with RRT recovery limited the analysis. Otherwise, no difference in renal recovery was observed between Black and White patients. In addition, high kappa light chain burden was associated with lower probability of renal recovery. Further studies are needed to expand upon these observations.