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Kidney Week

Abstract: SA-PO127

Hyperuricemia and Kidney Function in Patients Diagnosed With Multiple Myeloma

Session Information

Category: Onconephrology

  • 1600 Onconephrology

Authors

  • Petreski, Tadej, Department of Nephrology, Clinic for Internal Medicine, University Medical Center Maribor, Maribor, Slovenia
  • Pulko, Nejc, Department of Hematology, Clinic for Internal Medicine, University Medical Center Maribor, Maribor, Slovenia
  • Sapek, Katja, Faculty of Medicine, University of Maribor, Maribor, Slovenia
  • Puljek, Sanja, Faculty of Medicine, University of Maribor, Maribor, Slovenia
  • Piko, Nejc, Department of Dialysis, Clinic for Internal Medicine, University Medical Center Maribor, Maribor, Slovenia
  • Bevc, Sebastjan, Department of Nephrology, Clinic for Internal Medicine, University Medical Center Maribor, Maribor, Slovenia
Background

Multiple myeloma (MM) is a common hematologic malignancy with a high incidence rate in the elderly. Its characteristics include hypercalcemia, anemia, renal impairment, and bone lesions. The presence of CKD makes the diagnosis more difficult, and treatment related morbidity and mortality may complicate management. However, less is known about the effect of serum uric acid in MM. The aim of our study was to assess the impact of hyperuricemia and CKD on survival of patients with MM.

Methods

We retrospectively included 42 Caucasian patients from the Hematology outpatient clinic (HOC) who were diagnosed with MM between 2015 and 2020. Average age was 69.5±11.5 years. We recorded past medical history, laboratory tests, and basic demographic data upon first visit to the HOC before treatment was initiated. CKD was defined as eGFR <45 ml/min/1.73m2 and hyperuricemia as serum uric acid >420 mmol/L.

Results

Included patients (54.8% female), who were observed for a median of 760.0 (IQR 746) days, had diabetes mellitus (23.8%), arterial hypertension (64.3%), previous malignant disease (14.3%), dyslipidemia (28.6%), CKD (31.8%), and hyperuricemia (35.7%). Their ECOG performance status (PS) median was 2.0 (IQR 2.0). Most common subtypes of MM were IgG kappa (40.5%), IgG lambda (19.0%), and free light chain lambda (16.7%). Kaplan-Meier survival analysis showed no difference in mortality between the CKD and non-CKD group, however there was a difference between the hyperuricemic and normouricemic group (p=0.007, Log Rank 7.185). Furthermore, the uricemic groups differed in median beta-2-microglobulin, 8.1 (IQR 10.7) and 4.5 (IQR 3.8) mg/L (p=0.021), serum calcium, 2.45 (IQR 0.38) and 2.13 (IQR 0.15) mmol/l (p<0.001), and presence of CKD, 62.5% and 19.2% (p=0.004), respectively. In Cox regression models, hyperuricemia remained a significant marker (p=0.03, Exp(B) 4.4, 95% CI 1.2-16.9), even when adjusted for age, sex, PS, variables that proved different in univariate analysis, and LDH and albumin.

Conclusion

Elevated serum uric acid levels showed to be a possible additional prognostic marker for patients diagnosed with MM regardless of baseline kidney function.