Kidney Week

Abstract: SA-PO0194

Best Estimated GFR at Follow-Up as a Fundamental Predictor of Overall Survival in Patients with Newly Diagnosed Multiple Myeloma

Session Information

• Onconephrology: MGRS, HSCT, Electrolytes, RCC, and More
  November 08, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Onconephrology

• 1700 Onconephrology

Authors

• Strufaldi, Fernando Louzada, Universidade de Sao Paulo Instituto do Cancer do Estado de Sao Paulo, São Paulo, SP, Brazil

Fernando Louzada Strufaldi, MD

• Lutf, Luciana Gil, Universidade de Sao Paulo Instituto do Cancer do Estado de Sao Paulo, São Paulo, SP, Brazil

Luciana Gil Lutf, MD

• Costalonga, Elerson, Universidade de Sao Paulo Instituto do Cancer do Estado de Sao Paulo, São Paulo, SP, Brazil

Elerson Costalonga, MD, PhD

• Caires, Renato A., Universidade de Sao Paulo Instituto do Cancer do Estado de Sao Paulo, São Paulo, SP, Brazil

Renato A. Caires, MD

• Mattedi, Francisco Zanotelli, Universidade de Sao Paulo Instituto do Cancer do Estado de Sao Paulo, São Paulo, SP, Brazil

Francisco Zanotelli Mattedi, MD

• Segura, Gabriela C., Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, SP, Brazil

Gabriela C. Segura, MD

• Seguro, Fernanda S., Universidade de Sao Paulo Instituto do Cancer do Estado de Sao Paulo, São Paulo, SP, Brazil

Fernanda S. Seguro, MD, PhD

• Martinez, Gracia A., Universidade de Sao Paulo Instituto do Cancer do Estado de Sao Paulo, São Paulo, SP, Brazil

Gracia A. Martinez, MD, PhD

• Costa e Silva, Veronica Torres, Universidade de Sao Paulo Instituto do Cancer do Estado de Sao Paulo, São Paulo, SP, Brazil

Veronica Torres Costa e Silva, MD, PhD

Background

Estimated glomerular filtration rate(eGFR) after treatment(AT) of patients(pts) with multiple myeloma(MM) is a better predictor of overall survival(OS) than renal impairment(RI) at diagnosis(AD). Our aim is to assess if the best eGFR at follow-up(FUP) is a better predictor of OS in pts with newly diagnosed(NDMM), compared to other parameters of kidney dysfunction(KD)

Methods

We screened adult pts with NDMM admitted for treatment at the Sao Paulo State Cancer Institute between January 2009 and December 2019. eGFR was determined by the 2021 CKD-EPI creatinine(Cr) equation in ml/min/1.73m²(eGFRcr). RI was defined as eGFRcr<40 or serum Cr>2.0mg/dL. Chronic Kidney Disease(CKD) criterion was eGFRcr<60, considering the lowest Cr value in the previous three months before diagnosis. Acute Kidney Injury(AKI) was stratified according to the KDIGO criteria. Best eGFRcr during FUP was the one based on the lowest Cr any time after treatment initiation. AT eGFRcr was the closest value after induction therapy and was used to evaluate renal recovery. Renal recovery was analyzed through classifying patients into 3 groups: No RI at diagnosis; RI AD with AT recovery, RI AD without recovery AT, and by the International Myeloma Working Group renal recovery criteria

Results

We enrolled 502pts. Median age was 62.0(54.8–69.5)y, 56.5% male. Median body mass index was 25.4(22.1–28.9)Kg/m². ECOG≥ 2 and international staging system stage III were observed in 294(58.6%) and 112(22.3%) of patients, respectively. The best eGFRcr during follow-up occurred 7(3–13)months after MM diagnosis. In the adjusted Cox regression models, among kidney parameters, the lowest eGFRcr during follow up had the strongest association with reduced OS(Table)

Conclusion

The best eGFRcr during follow up might be a better predictor of OS than RI AD and other parameters of kidney dysfunction in pts with NDMM

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025rhamj7x3