Böbrek Fonksiyon Bozukluğu Olan Multipl Myelom Olgularının Demografik ve Laboratuvar Özellikleri

Amaç: Hastanemizde tanı alan myelom nefropatili olguların demografik ve laboratuvar özelliklerin prognostik etki- leri ile, uygulanan tedavilerin böbrek fonksiyonlarını düzeltici etkilerinin karşılaştırılmasını amaçladık. Yöntem ve Gereçler: Klinikte takip ettiğimiz 16 myelom nefropatili (12 erkek 4 kadın, yaş ortalaması 56±17)olguyu retrospektif olarak inceledik. Hastaların demografik özellikleri laboratuar parametreleri değerlendirildi.Akut böbrek hasarı varlığı KDIGO kriterlerine göre belirlendi. Kemoterapi olarak 10 olguya VAD, 5 olguya MPprotokolleri uygulandı. Serum kreatinin düzeyinde en az %25'lik düşme veya hemodiyaliz tedavisine ara verilenlertedaviye yanıt alınan olgular olarak kabul edildi. P0.05).Serum kalsiyum düzeyi böbrek fonksiyonları düzelenlerde (13,5±1,7 mg/dl), düzelmeyenlerden (9,8±1,1 mg/dl)daha yüksekti (P

Demographic and Laboratory Features of Multiple Myeloma Patients with Renal Dysfunction

Aim: The aim of the present study was to compare demographic and laboratory features among patients diagnosedwith myeloma nephropathy and compare efficiency of various therapies in improving kidney functions. Material and Methods: The medical records of 16 patients (12 males, 4 females, mean age was 56±17 years), whowere followed at our clinic due to myeloma nephropathy, were retrospectively reviewed. Demographic features andlaboratory parameters of the patients were evaluated. The presence of acute kidney injury was determined accord- ing to KDIGO criteria. As a chemotherapy protocol, 10 cases received VAD and 5 cases received MP protocols. Thepatients, who achieved at least 25% reduction in serum creatinine level or suspended hemodialysis, were consideredresponders. A p value 0.05). Serum calcium level wassignificantly higher in responders (13.5±1.7 mg/dl) compared to non-responders (9.8±1.1 mg/dl) (P

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1. Haznedar R. Plazma hücresi bozuklukları. Temel İç Hastalıkları Kitabı, (eds: Hiçin G, Ünal S, Biberoğlu K, ve ark.). Güneş Kita- bevi. 1996;1326-1332 2. Barlogie B, Shaughnessy J, Munshı N, Ebstein J. Plasma cell myeloma. Williams Hematology. Mc Graw Hill (eds: Beutler E, Lichtman MA, Coller BS, Kipss TJ.). Sixth Edition 2001;1279- 1304. 3. Goldschmidt H, Lannert H, Bommer J, Ho AD. Multiple myeloma and renal failure. Nephrol Dial Transplant. 2000;15:301-304. 4. Stompor T, Zablocki M, Pankrac K. Renal involvement in multiple myeloma. Pol Arch Med Wewn. 2012;122(9):443-448. 5. Kastritis E, Terpos E, Dimopoulos MA. Current treatments for re- nal failure due to multiple myeloma. Expert Opin Pharmacother. 2013 Aug;14(11):1477-1495. doi:10.1517/14656566.2013.803068. 6. Al-Farsi K. Multiple myeloma: an update. Oman Med J. 2013 Jan;28(1):3-11. doi: 10.5001/omj.2013.02. 7. Gerth J, Sigusch H, Illner N, Busch M, Muegge LO, Lehmann T, et al. Wolf G. Renal manifestations of light chain associated diseases- epidemiology and prognosis. Dtsch Med Wochenschr. 2013 Feb; 138(7):305-12. doi:10.1055/s-0032-1332864. Article in German. 8. Batuman V. The pathogenesis of acute kidney impairment in pa- tients with multiple myeloma. Adv Chronic Kidney Dis. 2012 Sep;19(5):282-6. doi:10. 1053/j.ackd.2012.04.009. 9. National kidney foundation. KDIGO Clinical practic guidelines for acute kidney injury. Vol 2, supplement 1, March 2012. 10. Clark AD, Shetty A, Soutar R. Renal failure and multiple myelo- ma: pathogenesis and treatment of renal failure and management of underlying myeloma. Blood Rev. 1999 Jun;13(2):79-90. 11. Davenport A, Merlini G. Myeloma kidney: advances in molecular mechanisms of acute kidney injury open novel therapeutic oppor- tunities. Nephrol Dial Transplant. 2012 Oct;27(10):3713-3718. doi:10.1093/ndt/gfs449. 12. Sakhuja V, Jha V, Varma S, Joshi K, Gupta KL, Sud K, et al. Re- nal involvement in multiple myeloma: a 10-year study. Ren Fail. 2000;22(4):465-477. 13. Sharland A, Snovvdon L, Douglas E, Gibson J, Tiller DJ. Hemo- dialysis: an appropriate therapy in myeloma-induced renal failure. Am J Kidney Dis. Dec 1997; 30(6):786-792. 14. Morgan G. Myeloma: diagnosis, complications and sup- portive care. Hematology. 2012 Apr;17 Suppl 1:S109-111. doi:10.1179/1024533312 X1333616 9 156177. 15. Govedarovic N, Vukicevic T. Current approaches to supporti- ve care in multiple myeloma. Srp Arh Celok Lek. 2011 Dec;139 Suppl 2:123-128. Article in Serbian. 16. Kourelis TV, Manola A, Moustakakis MN, Bilgrami SF. Role of plasma exchange in the treatment of myeloma nephropathy: expe- rience of one institution and systematic review. Conn Med. 2013 Mar;77(3):147-151.