Clinical features of patients with renal insufficiency due to multiple myeloma and risk factors of renal insufficiency

OBJECTIVE:To study the clinical features of patients with multiple myeloma(MM)accompanied by renal insufficiency,and investigate the related risk factors of renal insufficiency.METHODS:A control study of clinical characteristics was performed among 91 patients with renal insufficiency due to MM and 165 patients with normal renal function in MM during the same period.RESULTS:Renal insufficiency was the initial presentation in 48(52.7%)of the 91 patients,30(62.5%)of the 48 patients were misdiagnosed,and the meantime was 6.3 months.The incidences of hypercalcemia,hyperuricemic,severe anemia,high serum M-protein concentration and lytic bone lesions in renal insufficiency group were significantly higher than those in the control group(χ2=11.399,3.982,101.275,11.280,7.180;P=0.001,0.046,0.000,0.001,0.007).The mortality of renal insufficiency group in 3 months and from 3 months to 12 months were 28.57%(26/91)and 15.38%(14/91),8.48%(14/165)and 7.27%(12/165)in control group,and the difference was significant(χ2=18.02,P0.005;χ2=4.23,P0.05).The patients survived more than one gear in renal insufficiency group were 19.78%(18/91),57.58%(95/165)in control group,and the difference was significant(χ2=34.08,P0.005).Logistic regression analysis identified 5 risk factors of renal insufficiency,including severe anemia,use of nephrotoxic drugs,high serum M-protein concentration,male,and hypercalcemia,but age,serum density of uric acid,type of serum M-protein,and Bence Jones proteinuria were not significantly associated with renal insufficiency.CONCLUSIONS:Renal insufficiency is a common early complication of MM,which often results in misdiagnosis.Hypercalcemia,severe anemia,high serum M-protein concentration,the male,especially use of nephrotoxic drugs were five dangerous factors for the occurrence of renal insufficiency in patients with MM.