Hong Kong Med J 2003;9:78-82 | Number 2, April 2003
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.
Key words: Dialysis; Kidney failure; Multiple myeloma; Survival
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