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: PO2185

Efficacy of Early Use of Double Filter-Based Extracorporeal Treatment Combined with Chemotherapy in Acute Myeloma Kidney

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

  • Zappulo, Fulvia, Nephrology Dialysis and Renal Transplantation Unit, S.Orsola University Hospital, Bologna, Italy
  • Donati, Gabriele, Nephrology Dialysis and Renal Transplantation Unit, S.Orsola University Hospital, Bologna, Italy
  • Maietti, Elisa, Biomedical and Neuromotor Sciences University of Bologna, Bologna, Emilia-Romagna, Italy
  • Scrivo, Anna, Nephrology Dialysis and Renal Transplantation Unit, S.Orsola University Hospital, Bologna, Italy
  • Comai, Giorgia, Nephrology Dialysis and Renal Transplantation Unit, S.Orsola University Hospital, Bologna, Italy
  • Baraldi, Olga, Nephrology Dialysis and Renal Transplantation Unit, S.Orsola University Hospital, Bologna, Italy
  • Gasperoni, Lorenzo, Nephrology Dialysis and Renal Transplantation Unit, S.Orsola University Hospital, Bologna, Italy
  • Pantani, Lucia, Hematology and Oncology Unit, L. & A. Seràgnoli, S.Orsola University Hospital, Bologna, Italy., Bologna, Emilia-Romagna, Italy
  • Zamagni, Elena, Hematology and Oncology Unit, L. & A. Seràgnoli, S.Orsola University Hospital, Bologna, Italy., Bologna, Emilia-Romagna, Italy
  • La Manna, Gaetano, Nephrology Dialysis and Renal Transplantation Unit, S.Orsola University Hospital, Bologna, Italy
Background

Before the introduction of modern chemotherapy, less than 25% of patients with AKI and Multiple Myeloma (MM) who required dialysis recovered sufficient renal function to no longer be dependent on dialysis, with a median overall survival of less than 1 year. Although impaired renal function has been a marker of poor prognosis there are may others factor involved in determining patient survival. We aimed to investigate the factors related to renal recovery and to an higher survival rate in MM patients.

Methods

A monocentric retrospective study was carried out enrolling 23 patients with biopsy-proven acute myeloma kidney and sFLC levels >1000 mg/l. Patients received Bortezomib-based chemotherapy and extracorporeal treatment for sFLC removal. For each session 2 dialyzers of the same kind were used and the dialytic dose was only related to the sFLC removal. The dialyzers had high absorptive properties: PMMA (polymethylmetacrylate; Filtryzer BK-F 2.1 m2 cut-off 20 kDa ); PEPA (poly ester polymer alloy; FDX or FDY 210-GW 2.1 m2, cut-off undisclosed).

Results

The factors that have been found to be significantly and independently associated with higher survival rate were: baseline serum albumin, reduction of sFLC at day 12 and day 30, reduction of sFLC at day 30 above 50%, number of session and dialysis independence.

Conclusion

Our analysis highlights the importance of the early treatment for removal of sFLC in AKI for MM. In fact the variable associated with higher survival rate are the reduction of sFLC at day 12 and at day 30 and number of session. These results indicate that the early removal of sFLC can guarantee a better outcome. Baseline serum albumin is also associated with survival rate and it demonstrates that it still carries a prognostic value in the population with AKI. This finding suggests the importance of albumin-sparing extracorporeal treatments. In fact alternative techniques, as HD-HCO, have been proposed for sFLC removal but they present high costs and albumin leakage.