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Kidney Week

Abstract: SA-PO190

Twenty-Eight Treatments of Acute Renal Failure Secondary to Multiple Myeloma (MM) with High Cutoff (HCO) Filters

Session Information

  • Onco-Nephrology: Clinical
    November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Onco-Nephrology

  • 1500 Onco-Nephrology

Authors

  • Berni, Ana, Lozano Blesa University Hospital, Zaragoza, Spain
  • Alvarez lipe, Rafael, Lozano Blesa University Hospital, Zaragoza, Spain
  • Coscojuela otto, Ana, Lozano Blesa University Hospital, Zaragoza, Spain
  • Dourdil, Victoria, Hospital Clinico Zaragoza, Zaragoza, Spain
  • Inigo Gil, Pablo J., Lozano Blesa University Hospital, Zaragoza, Spain
Background

Our hospital is a reference in Spain for the treatment of acute renal failure secondary to multiple myeloma with HCO filters. We present our experience with 28 treatments.

Methods

Treatment indication required the diagnosis of MM, the presence of AKI requiring dialysis, a free light chains (FLC) level greater than 500 mg/L. The patients were analytically monitored by blood sampling at the start and the end of the hemodialysis session. The dialysis protocol used was the following: daily dialysis for 6 sessions, ultrapure water, HCO filter of 2,1 meters. To pass then to dialyze every other day until reaching sFLC levels below 500 mg/L, or until the recovery of a renal function. The duration of the sessions was 6 hours. 2 vials of 20% human albumin, 50 mL, were infused in a protocolized manner during the last half hour of dialysis.

Results

28 treatments were performed on 25 patients. The average age of the patients was 60.2 years; 17 men and 8 women. The chemotherapy regimen was based on Bortezomib and Dexamethasone as first line. 24 of the 28 cases (85.7%) recovered renal function to allow independent dialysis. At 3 months, the number of patients who remain independent of dialysis was 21 of the 28 cases treated (75%), 13 patients presented MM with Lambda chains and 12 were Kappa. The average reduction of FLC by dialysis session was 63%. The reduction in sFLC beginning and the end of the treatment reached an average of 91%. Reviewing our data in May 2019, after 8 years of treatment, we have found that 52% of patients live independently of hemodialysis, we have also compared our results with the studies that more patients have treated and we have proven that our results are beter.

Conclusion

Given our experience, we believe that prolonged hemodialysis with HCO filters is effective, safe and with a high rate of renal recovery, Thelefore its hould be the treatment option chosen, together with chemotherapy, in all patients with multiple myeloma, cylinder nephropathy and acute renal failure requiring dialysis