Analysis Of Related Factors Of Renal Function Recovery In Multiple Myeloma Patients With Renal Impairment

Objective:To explore the predictive indicators of renal function recovery in patients with multiple myeloma(MM)and renal impairment(RI),so as to provide a theoretical basis for the treatment,efficacy evaluation and prognosis of MM patients with RI.Methods:From January 2013 to November 2020,57 MM patients with RI were selected.The general clinical data,laboratory indexes before and after chemotherapy were collected.According to the changes of glomerular filtration rate(GFR)before and after treatment,the patients were divided into two groups: renal function improvement group and renal function progress group.Gender,age,systolic blood pressure,diastolic blood pressure,onset symptoms,Department of first visit,ISS stage,immune classification,urinary protein,chemotherapy regimen,urea nitrogen and β2-microglobulin(β2-MG)before and after chemotherapy were analyzed.The relationship between serum uric acid,calcium,phosphorus,lactate dehydrogenase,albumin,globulin,hemoglobin,platelet,immunoglobulin(Ig G,Ig A,Ig M),bone marrow cytology and the recovery of renal function.The collected data were analyzed by SPSS 25.0 and excel statistical software.The difference was statistically significant(P < 0.05).Result:1.Among 57 MM patients with RI,there were 36 males(63.2%)and 21 females(36.9%);the onset age was between 34-79 years old,the median age was 62 years old,11 cases(19.2%)were under 50 years old,30 cases(52.6%)were 50-65 years old,and16 cases(28.1%)were over 65 years old;36 cases(63.1%)first visited the Department of Hematology,and the other departments were nephrology,cardiology and spine surgery.2.In the immune classification,Ig G type was the most common,followed by Ig A type and light chain type,Ig M type was the least;ISS stages were stage II and III.3.Univariate analysis showed that there were significant differences between the two groups in light chain type,treatment plan,urine protein(urine protein negative rate),renal function level(blood urea nitrogen,β2-MG,blood uric acid),blood calcium level before treatment,albumin level before treatment and hemoglobin level after treatment(P < 0.05).4.Multivariate logistic regression analysis showed that serum uric acid level and albumin level before treatment were predictors of renal function recovery in MM patients with RI.Conclusion:1.MM patients often complicated with RI,but after active chemotherapy and symptomatic treatment,RI can have a higher reversal rate;2.patients with higher albumin level before treatment and lower serum uric acid level after treatment are more likely to recover renal function,suggesting the importance of early and rapid start of treatment to reduce serum uric acid level;3.the therapeutic regimen containing bortezomib has a better reversal effect on renal function than others Case.