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Abstract: FR-PO0443

Mortality in Patients with Multiple Myeloma on Dialysis

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Canzani, Maria Belen, Universidad de la Republica Uruguay, Montevideo, Uruguay
  • Riva, Eloisa, Universidad de la Republica Uruguay, Montevideo, Uruguay
  • Ferreiro, Alejandro, Registro Uruguayo de Diálisis, Montevideo, Uruguay
  • Gonzalez-Bedat, Maria Carlota, Registro Uruguayo de Diálisis, Montevideo, Uruguay
  • Luzardo, Leonella, Registro Uruguayo de Diálisis, Montevideo, Uruguay
Background

Multiple myeloma (MM) is characterized by the neoplastic proliferation of plasma cells producing a monoclonal immunoglobulin. It can cause renal failure, and occasionally, extreme renal disease. Bortezomib, the first FDA-approved proteasome inhibitor for treating MM reduces tumor growth. The availability of bortezomib determined a change in the evolution of patients. We have accumulated strong evidence regarding evolution and prognosis of these patients once they start dialysis.

Methods

The Uruguayan Dialysis Registry (UDR) is a mandatory registry with information of all patients receiving chronic dialysis in the country. This is a descriptive and retrospective study, based on the UDR, the Glomerulopathies Prevention and Treatment Program and the data from state office that finances treatment. We performed an analysis based on whether or not the patient had received bortezomib, which has been available in our country since 2010.

Results

We analyzed 287 patients, mean age 65.1±12.1 years, 7,7% peritoneal and 92.3% hemodialysis. 24.4% of patients had a renal biopsy, with amyloidosis being the most frequent diagnosis. The survival of the entire population was 29 (IQR 14;37) months. We observed an increase in the incidence rate of patients with MM, from 0.55 pmp in the first five-year period (1981-1984) to 3.77 pmp in the last period (2015-2020) (Fig 1). The survival of patients who received the drug was higher (41; 95% CI 31-52 months) than that of those who did not (26; 95% CI 21-32 months) (p=0.014) (Fig 2).

Conclusion

Patients treated with bortezomib had a higher survival rate, which was surely contributed to by the improvement in nephrological care in recent years.

Figure 1. Evolution of MM incident patients on chronic dialysis.

Digital Object Identifier (DOI)