Abstract: SA-PO203
Prognostic Factors Associated with Renal Survival and Mortality of Renal Involvement Proven by Biopsy Associated with Monoclonal Gammopathy
Session Information
- Onconephrology: Immunological Cross-Talk
November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Onconephrology
- 1700 Onconephrology
Authors
- Gomez Jiménez, Sebastian, Universidad de Antioquia, Medellin, Colombia
- Cano Rodas, Simón, Universidad de Antioquia, Medellin, Colombia
- Arias, Luis Fernando, Universidad de Antioquia, Medellin, Colombia
- Carvajal, Jose Nelson, Universidad de Antioquia, Medellin, Colombia
- Rodelo Ceballos, Joaquin, Universidad de Antioquia, Medellin, Colombia
Background
Monoclonal gammopathies can generate a wide and diverse renal compromise that can condition the patient's prognosis. This study seeks to determine those factors associated with renal survival and mortality.
Methods
A retrospective cohort study of 98 patients older than 18 years with biopsy-proven renal involvement due to monoclonal gammopathy was conducted. For the analysis of renal and patient survival, the Kaplan Meier method was obtained, renal survival curves were compared with the histological diagnosis and the Log Rank Test was obtained. To determine the predictive factors at the time of biopsy that correlate with death and ESKD, univariate and multivariate cox analyzes were performed.
Results
The need for RRT was related to the combined outcome of ESKD and death (HR 4.86 CI 2.01-11.79). A GFR at the time of biopsy less than 30ml/min/1.73 was correlated with an increased risk of ESKD (HR 4.02 CI 1.38-11.71). Amyloidosis and age over 60 years are factors associated with higher mortality (HR 2.38, IC 1.22-4.86 and 1.96 IC 1.06-3.61 respectively). The presence of tubulopathy (myeloma Kidney) in renal biopsy was associated with better survival compared with other histological compromises (p 0.05).
Conclusion
The requirement of RRT and GFR less than 30 ml/min/1.73 were associated with adverse outcomes in patients with MGRS. Amyloidosis and age are factors negatively related to patient survival.
Combined death and end stage chronic kidney disease
| Univariate (HR) | Multivariate (HR) | |
| Age <60 years | 1.58 (CI 0.88-2.85, p 0.12) | 1.36 (CI 0.73-2.56, p 0.32) |
| GFR at biopsy ≤ 30 ml/min/1.73 | 3.53 (CI 1.90-6.54, p 0.000) | 1.21 (CI 0.48-3.04, p 0.68) |
| Amyloidosis | 1.08 (CI 0.61-1.92, p 0.76) | 1.28 (CI 0.70-2.34, p 0.41) |
| Need for RRT | 5.63 (CI 3.10-10.24, p 0.000) | 4.86 (CI 2.01-11.79, p 0.000) |
Funding
- Private Foundation Support