摘要
Abstract
To study clinical features of the patients with multiple myeloma (MM) accompanied by renal insufficiency and investigate the related risk factors of renal impairment. Methods: A control study of clinical characteristics was performed between 91 patients with renal insufficiency due to MM and 165 patients with normal renal function in MM during the same period. The data were statistically analyzed by chi-square test and logistic regression analysis. Results: Renal insufficiency was the initial presentation in 48 (52.7%) of the 91 patients, and 30 (62.5%) of the 48 patients were misdiagnosed. The prognosis of group with renal insufficiency was significantly poorer than that of group with normal renal function: mortality in 3 months, 3 months-1 year was 26/91 vs 14/165 (P＜0.0001), 14/91 vs 12/165 (P＜0.05) respectively, and patients survived ≥1 year was 18/91 vs 95/165 (P＜0.0001). The incidence of hypercalcemia, hyperuricemic,severe anemia, high serum M-protein concentration and lytic bone lesions were significantly higher in renal insufficiency group than those in control group (P＜0.05). Logistic regression analysis identified 5 risk factors of renal impairment, including, severe anemia (Exp(β)=13.819, P＜0.0001), use of nephrotoxic drugs (Exp(β)=6.217, P=0.001), high serum M-protein concentration (Exp(β)=5.026, P=0.001), male (Exp(β)=3.745, P=0.006), and hypercalcemia (Exp(β)=3.472, P=0.006), but age, serum density of uric acid, type of serum M-protein, and Bence Jones proteinuria were not significantly associated with renal insufficiency. Conclusion: Renal insufficiency was a common early complication of MM, which often resulted in misdiagnosis. The status of these patients tended to be very bad, with many other complications,when MM was diagnosed, so their prognosis was poor. The occurrence of renal insufficiency in patients with MM and hypercalcemia, severe anemia, high serum M-protein concentration, especially use of nephrotoxic drugs should be alert.关键词
多发性骨髓瘤/肾功能不全/临床特征/危险因素Key words
multiple myeloma/renal insufficiency/clinical feature/risk factor分类
医药卫生
