ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO2171

AKI Secondary to Multiple Myeloma: Complications of Treatment with High Cut-Off Filters

Session Information

  • Onco-Nephrology - 1
    October 22, 2020 | Location: On-Demand
    Abstract Time: 10:00 AM - 12:00 PM

Category: Onco-Nephrology

  • 1500 Onco-Nephrology

Authors

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

Acute kidney injury is a frequent complication of MM that can affect 18 to 56% of patients and more than 10% end up needing dialysis.

One of the drawbacks associated with the technique is attributed to the albumin loss. The other complications are related with the dialysis technique itself, especially infections.

Methods

We have performed 28 treatments of hemodialysis with High cut off filters (HD-HCO).

The HD-HCO protocol includes daily dialysis session of 6 hours during the first 6 days to subsequently switch to dialysis every other day until free light chains levels below 500 mg / L, or until the recovery of renal function allows the independence of dialysis.

All these patients have a chemotherapy regimen based on Bortezomib (25 of the 28 treatments) and Dexamethasone (28 treatments).

A retrospective analysis of the 28 treatments that are performed with HD-HCO after 8 years of experience (July 2011 to May 2019) to demostrate the presence of the same complications as the conventional HD.

Results

Loss of albumin is one of the main drawbacks of the technique. Our patients had no changes in albumin levels due to the fact that our protocol includes the infusion of 2 vials of 20% albumin of 50 ml. at the end of each HD-HCO session.

Another concern is intradialytic complications. We have reviewed this topic and our results show that patients in HD-HCO do not present a greater number of complications than those who dialyze with HD-HD or other conventional dialysis. The total number of sessions was 298. 21 patients developed hypotension (7%). The number of sessions in which the patient presented fever was 6 (2%), coagulation of the circuit occurred in 23 sessions (7,7%). The catheter dysfunction (when it does not allow to reach 250 ml/min of blood flow) in 26 times (8.7%) and only 13 times the replacement of the catheter (4.26%) was necessary, consequently, in those who required a greater number of dialysis sessions. In only 1 case (patient who required 27 sessions) to place a permanent Tesio catheter was necessary. Figure 1

Conclusion

Our findings indicate that the HD-HCO has the same safety profile as the conventional HD. There is no serious infectious complications in our patients despite of the fact that all of them are immunosuppressed patients (AKI secondary to Multiple Myeloma in patients treated with chemotherapy).