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Renal impairment in patients with multiple myeloma
CC Chow, KL Mo, CK Chan, HK Lo, KS Wong, JCW Chan
Department of Medicine, Pamela Youde Nethersole Eastern Hospital,
3 Lok Man Road, Chai Wan, Hong Kong
OBJECTIVES. To determine the incidence of multiple
myeloma in the Eastern District of Hong Kong Island, the degree
of renal impairment at presentation, and its relationship with haematological
and biochemical parameters and survival.
DESIGN. Retrospective study.
SUBJECTS AND METHODS. Patients with myeloma who
were admitted to a regional hospital in Hong Kong from January 1994
to March 2000 were included. Demographic data, type and stage of
multiple myeloma, degree of renal impairment, haematological and
biochemical parameters, and survival data were analysed.
RESULTS. There were 64 patients (28 male, 36 female)
in the study. The incidence rate for multiple myeloma in this group
was 1.78 per 100 000 population. Immunoglobulin G (53.1%) was the
most common type of multiple myeloma seen, followed by immunoglobulin
A (29.7%), light-chain (12.5%), and immunoglobulin D (4.7%). Nineteen
(29.7%) patients had serum creatinine levels of greater than 177
µmol/L at presentation. Renal impairment was more common in
patients with light-chain multiple myeloma (P=0.081). The serum
creatinine level was not significantly correlated with haemoglobin
level (r= –0.21), platelet count (r=0.04), serum
calcium level (r=0.08), or albumin level (r= –0.03).
The median survival time for patients with multiple myeloma was
592 days (95% confidence interval, 229-955). Serum creatinine level
at presentation was significantly associated with survival (P=0.017).
Patients with a creatinine level of less than 400 µmol/L had
longer survival (P=0.042). Infection was the most common cause of
death (32.8%).
CONCLUSION. The incidence rate noted was comparable
to other published studies. Renal impairment at resentation was
common in patients with multiple myeloma and was associated with
poor survival.
Hong Kong Med J 2003;9:78-82
Key words: Dialysis; Kidney failure; Multiple myeloma;
Survival
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