Kidney Week

Abstract: SA-PO173

Impact of Kidney Impairment Recovery on Survival of Patients with Newly Diagnosed Multiple Myeloma

Session Information

• Onconephrology: Kidney Outcomes during Cancer Treatment and Nephropathies
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Onconephrology

• 1700 Onconephrology

Authors

• Strufaldi, Fernando Louzada, Universidade de Sao Paulo Instituto do Cancer do Estado de Sao Paulo, Sao Paulo, São Paulo, Brazil

Fernando Louzada Strufaldi, MD

• Lutf, Luciana Gil, Universidade de Sao Paulo Instituto do Cancer do Estado de Sao Paulo, Sao Paulo, São Paulo, Brazil

Luciana Gil Lutf, MD

• Caires, Renato A., Universidade de Sao Paulo Instituto do Cancer do Estado de Sao Paulo, Sao Paulo, São Paulo, Brazil

Renato A. Caires, MD

• Mattedi, Francisco Zanotelli, Universidade de Sao Paulo Instituto do Cancer do Estado de Sao Paulo, Sao Paulo, São Paulo, Brazil

Francisco Zanotelli Mattedi, MD

• Costalonga, Elerson, Universidade de Sao Paulo Instituto do Cancer do Estado de Sao Paulo, Sao Paulo, São Paulo, Brazil

Elerson Costalonga, MD, PhD

• Seguro, Fernanda S., Universidade de Sao Paulo Instituto do Cancer do Estado de Sao Paulo, Sao Paulo, São Paulo, Brazil

Fernanda S. Seguro, MD, PhD

• Martinez, Gracia A., Universidade de Sao Paulo Instituto do Cancer do Estado de Sao Paulo, Sao Paulo, São Paulo, Brazil

Gracia A. Martinez, MD, PhD

• Costa e Silva, Veronica Torres, Universidade de Sao Paulo Instituto do Cancer do Estado de Sao Paulo, Sao Paulo, São Paulo, Brazil

Veronica Torres Costa e Silva, MD

Background

It has recently been suggested that recovery of Renal Impairment(RI) after treatment(AT) of patients(pts) with multiple myeloma (MM) is a better predictor of overall survival(OS) than RI at diagnosis(AD). Our aim is to assess the impact of RI recovery on the OS of pts with newly diagnosed(NDMM)

Methods

We screened adult pts with NDMM admitted for treatment at the Sao Paulo State Cancer Institute between January 2009 and September 2018. Estimated glomerular filtration rate(eGFR) was determined by the 2021 CKD-EPI creatinine(Cr) equation in ml/min/1.73m². RI was defined as eGFR<40 or serum Cr>2.0mg/dL. Chronic Kidney Disease (CKD) criteria was eGFR<60ml/min/1.73m², considering Cr in the previous three months before MM diagnosis. Acute Kidney Injury (AKI) was stratified according to the KDIGO criteria. Patients were classified into 3 groups: (1)no RI at diagnosis, (2)RI AD with recovery AT, (3)RI AD without recovery AT

Results

We enrolled 429 pts. Median age was 61.7(54.1–69.5)y, 58.1% male. Median Charlson comorbidity index was 4.0(3.0–5.0). International staging system III was found in 37.9%. Novel agents(bortezomib or thalidomide) were used in 70.8% pts. eGFR AD and AT were 70.9(40.7–98.7) and 93.2(62.7-104.1)ml/min/1.73m², respectively. AD, CKD, RI, and AKI stage 3 were observed in 26.3, 24.0, and 12.1% of patients, respectively. In the adjusted Cox regression models, among kidney variables, only the lowest eGFR AT was associated with worse OS(Table).

Conclusion

The lowest eGFR AT might be a better predictor of OS than RI AD in pts with NDMM

Each model was adjusted for age, Charlson index, international staging system stage 3, body mass index categorization, and usage of novel chemotherapy agent(thalidomide or bortezomib).eGFR: estimated glomerular filtration rate