Abstract: PUB150
Long-Term Outcomes in Adult Patients with Biopsy-Proven Diagnosis of Paraprotein-Mediated Kidney Disease
Session Information
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Ploussard, Brett F., The Permanente Medical Group Inc, Oakland, California, United States
- Poyan Mehr, Ali, The Permanente Medical Group Inc, Oakland, California, United States
Background
Paraprotein-mediated kidney disease (PKMD) encompasses a heterogeneous group of kidney disorders caused by monoclonal immunoglobulins including amyloidosis, monoclonal immunoglobulin deposition disease (MIDD), cast nephropathy, proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMID), and others. Despite growing recognition, prognostic factors and treatment responses across histopathological subtypes remain poorly characterized.
Methods
We conducted a retrospective cohort study of all adults with a biopsy-diagnosis of PMKD identified within Kaiser Permanente between 01/01/2010-12/31/2024. Baseline variables include demographics, anthropometrics, kidney biopsy characteristics, kidney function, proteinuria, hematuria, serum and urine electrophoresis, serum and urine immunofixation, and treatment characteristics. Primary outcomes include time to hematologic remission, time to adverse renal outcomes (renal replacement therapy or transplant), adverse cardiovascular events, hospitalizations, ICU admission, new malignancy and death.
Results
94 patients with a biopsy-diagnosis of PMKD were identified. The most common subtypes were light chain deposition disease (n=22), PGNMID (n=20), cast nephropathy (n=16), amyloidosis (n=16), and MIDD (n=12). The most frequently associated hematologic diagnosis was multiple myeloma. Additional analysis is being conducted to identify independent factors associated with event-free survival and to identify predictors of treatment response as well as those most at risk for progression of chronic kidney disease, end-stage renal disease, adverse cardiovascular and hematologic events, and death.
Conclusion
This study provides a sizeable cohort of patients with various PMKDs and reports on their long-term outcomes and response to therapies from a large U.S. integrated health system.