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myeloma And kidney injury

P Fabbrini, K Finkel, M Gallieni, G Capasso, M Cavo, A Santoro, S Pasquali
Acute kidney injury (AKI) is a frequent complication of multiple myeloma and is associated with increased short-term mortality. Additionally, even a single episode of AKI can eventually lead to end-stage renal disease (ESRD), significantly reducing quality of life and long-term survival. In the setting of multiple myeloma, severe AKI (requiring dialysis) is typically secondary to cast nephropathy (CN). Renal injury in CN is due to intratubular obstruction from precipitation of monoclonal serum free light chains (sFLC) as well as direct tubular toxicity of sFLC via stimulation of nuclear factor (NF)κB inflammatory pathways...
October 18, 2016: Journal of Nephrology
Maria Gavriatopoulou, Evangelos Terpos, Efstathios Kastritis, Meletios A Dimopoulos
INTRODUCTION: Renal impairment (RI) is one of the most common complication of multiple myeloma (MM). RI is present in almost 20% of MM patients at diagnosis and in 40%-50% of patients during the course of their disease. AREAS COVERED: Biology along with tools for diagnosis and management of RI are reported in this paper. Papers published in PubMed and reported abstracts up to May 2016 were used. EXPERT OPINION: Moderate and severe RI increases the risk of early death; thus rapid intervention and initiation of anti-myeloma treatment is essential and improves renal outcomes in RI patients...
September 27, 2016: Expert Opinion on Pharmacotherapy
N E Scholpa, R T Kolli, M Moore, R D Arnold, T C Glenn, B S Cummings
This study determined the anti-neoplastic activity and nephrotoxicity of epigenetic inhibitors in vitro. The therapeutic efficacy of epigenetic inhibitors was determined in human prostate cancer cells (PC-3 and LNCaP) using the DNA methyltransferase inhibitor 5-aza-2'-deoxycytidine (5-Aza) and the histone deacetylase inhibitor trichostatin A (TSA). Cells were also treated with carbamazepine (CBZ), an anti-convulsant with histone deacetylase inhibitor-like properties. 5-Aza, TSA or CBZ alone did not decrease MTT staining in PC-3 or LNCaP cells after 48 h...
October 25, 2016: Chemico-biological Interactions
Punit Yadav, Mark Cook, Paul Cockwell
BACKGROUND: Renal impairment (RI) is a common complication of multiple myeloma (MM). Around 50% of patients with MM have RI at presentation, and up to 5% require dialysis treatment. Severe acute kidney injury (AKI) as a cause of RI is a particular challenge as historically the survival of patients who sustain this complication and require dialysis is very poor. However, in this current period, survival is improving and the focus is on optimum use of novel chemotherapies and the evaluation of extra-corporeal therapies for removal of serum immunoglobulin light chains...
March 2016: Kidney Diseases
Hao Shi, Zijin Chen, Jingyuan Xie, Nan Chen
BACKGROUND: Multiple myeloma (MM) is a clonal B-cell malignancy of the bone marrow. Renal impairment is a common complication of MM. So far, there is no systematic overview of MM-induced kidney disease in China. SUMMARY: The incidence of MM is 0.6/100,000 in China. Twenty-four, 19.7, and 30.8% of all patients with MM had renal insufficiency [defined by serum creatinine (Scr) ≥2 mg/dl] at diagnosis in China mainland, Hong Kong and Taiwan, respectively. Novel criteria based on the estimated glomerular filtration rate measurements are recommended for the assessment of renal function in patients with MM with stabilized Scr...
March 2016: Kidney Diseases
(no author information available yet)
No abstract text is available yet for this article.
June 2016: Annals of Intensive Care
Imen Gorsane, S Barbouch, M Mayara, K Ben Abdelghani, R Goucha, F Ben Hamida, H Hedri, T Ben Abdallah
To determine the features of the different forms of kidney diseases associated with multiple myeloma (MM), we retrospectively studied 144 patients with kidney injury and MM at our institute from 1974 to 2014. The mean age of the patients was 60.1 years and the male:female ratio was 1.25. Renal disease was concomitant with the discovery of MM in 92% of cases. The mean follow-up of our patients was 2.1 years. Initial renal insufficiency was found in 131 (91%) patients. Cast nephropathy of the distal tubule was found in 110 (26%) patients, renal amyloidosis in 16 (11...
May 2016: Saudi Journal of Kidney Diseases and Transplantation
Hans U Gerth, Michele Pohlen, Dennis Görlich, Gerold Thölking, Martin Kropff, Wolfgang E Berdel, Hermann Pavenstädt, Marcus Brand, Philipp Kümpers
BACKGROUND: High-cut-off hemodialysis (HCO-HD) can effectively reduce high concentrations of circulating serum free light chains (sFLC) in patients with dialysis-dependent acute kidney injury (AKI) due to multiple myeloma (MM). Therefore, the aim of this study was to analyze renal recovery in a retrospective single-center cohort of dialysis-dependent MM patients treated with either conventional HD (conv. HD) or HCO-HD. METHODS AND RESULTS: The final cohort consisted of 59 patients treated with HCO-HD (n = 42) or conv...
2016: PloS One
David J Reeves, Lindsay M Saum, Ruemu Birhiray
PURPOSE: A case of apparent rasburicase-induced methemoglobinemia and acute kidney injury treated with i.v. ascorbic acid because of suspected glucose-6-phosphate dehydrogenase (G6PD) deficiency is reported. SUMMARY: A 46-year-old African-American man with a recent diagnosis of multiple myeloma and renal insufficiency was admitted to the hospital with a cough, hemoptysis, and fatigue. His medical history included hypertrophic cardiomyopathy, ventricular tachycardia, attention deficit/hyperactivity disorder, and pleural effusion...
May 1, 2016: American Journal of Health-system Pharmacy: AJHP
Lavjay Butani, Jonathan Ducore
Cast nephropathy is the most common manifestation of renal injury in patients with multiple myeloma but is rarely reported in other conditions. We are reporting our experience in caring for a teenager with a metastatic neuroendocrine carcinoma who developed rapidly progressive kidney injury that advanced to end-stage renal disease. On renal biopsy extensive tubular necrosis and intratubular eosinophilic casts were noted. This previously unreported finding should prompt oncologists to closely monitor for such a complication in patients with secretory tumors...
July 2016: Journal of Pediatric Hematology/oncology
Rania Kheder El-Fekih, Hassan Izzedine
The introduction of lenalidomide into the therapeutic arsenal of hematologic malignancies has represented an important step forward in the management of multiple myeloma. However, its use is associated with several toxicities including kidney injury. The present review examines the drug's pharmacokinetics, discusses the main adverse renal effects that are associated with lenalidomide treatment, and makes recommendations for dosage adjustment in patients with underlying renal impairment.
May 2016: Bulletin du Cancer
Hideki Kato, Yoshihide Fujigaki, Shinichiro Asakawa, Yutaka Yamaguchi, Hiroshi Uozaki, Atsushi Komatsuda, Michio Nagata, Shunya Uchida
Multiple myeloma presents with various kidney injuries, including cast nephropathy, light chain deposition disease, and amyloidosis. Cast nephropathy is the most common form and mostly consists of monoclonal immunoglobulin light chains with Tamm-Horsfall protein. Immunoglobulin light chain (AL) amyloidosis may affect all compartments of the kidney, but it is rare in the tubuli. We herein present a rare case with rapid progression of renal failure caused by the co-occurrence of intratubular amyloidosis and cast nephropathy due to multiple myeloma...
2015: Internal Medicine
Michael Darmon, François Vincent, Emmanuel Canet, Djamel Mokart, Frédéric Pène, Achille Kouatchet, Julien Mayaux, Martine Nyunga, Fabrice Bruneel, Antoine Rabbat, Christine Lebert, Pierre Perez, Anne Renault, Anne-Pascale Meert, Dominique Benoit, Rebecca Hamidfar, Mercé Jourdain, Benoit Schlemmer, Sylvie Chevret, Virginie Lemiale, Elie Azoulay
BACKGROUND: Cancer patients are at high risk for acute kidney injury (AKI), which is associated with high morbidity and mortality. We sought to appraise the incidence, risk factors, and outcome of AKI in a large multicentre cohort study of critically ill patients with haematological malignancies. METHODS: We used a retrospective analysis of a prospectively collected database. The study was carried out in 17 university or university-affiliated centres in France and Belgium between 2010 and 2012...
December 2015: Nephrology, Dialysis, Transplantation
Stanislas Faguer, Murielle Roussel
No abstract text is available yet for this article.
June 2016: European Journal of Haematology
N A Konovalov, A G Nazarenko, D S Asyutin, A V Solenkova, R A Onoprienko, B A Zakirov, S Yu Timonin, I U Cherkiev, M A Martynova, A V Kosyr'kova, V A Korolishin
INTRODUCTION: Every year the number of cancer patients increases due to increased life expectancy. According to various sources, metastases in the spine are found during autopsy in 30-90% of patients with a history of cancer. So far, there have been no full-scale studies of the quality of life of patients with various metastatic tumors of the spine who underwent surgical treatment in Russian literature. The main objective of this study was to demonstrate the need for implementing the comprehensive treatment of patients with metastases in the spine and target setting as the main tool to identify the factors that adversely affect the patients' quality of life...
2015: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Mathieu Rousseau-Gagnon, Mohsen Agharazii, Sacha A De Serres, Simon Desmeules
INTRODUCTION: In cases of myeloma cast nephropathy in need of haemodialysis (HD), reduction of free light chains using HD with High-Cut-Off filters (HCO-HD), in combination with chemotherapy, may be associated with better renal recovery. The aim of the present study is to evaluate the effectiveness of haemodiafiltration (HDF) in reducing free light chain levels using a less expensive heat sterilized high-flux polyphenylene HF dialyzer (HF-HDF). METHODS: In a single-centre prospective cohort study, 327 dialysis sessions were performed using a 2...
2015: PloS One
Sung-Hoon Jung, Jae-Sook Ahn, Deok-Hwan Yang, Min-Seok Cho, Jae-Yong Kim, Seo-Yeon Ahn, Yeo-Kyeoung Kim, Hyeoung-Joon Kim, Je-Jung Lee
BACKGROUND: A change in urine output has been recently recognized as a valuable biomarker of acute kidney injury that is associated with mortality in critically ill patients. We investigated the prognostic impact of oliguria for survival outcomes in multiple myeloma (MM) patients presenting with renal impairment (RI). METHODS: Retrospective data on 98 patients with MM and RI, who received initial treatment with novel therapies, were analyzed. Oliguria was defined as a urine output of <0...
September 2015: Blood Research
Mariam P Alexander, Samih H Nasr, Paul J Kurtin, Edward T Casey, Loren P Herrera Hernandez, Mary E Fidler, Sanjeev Sethi, Lynn D Cornell
Renal extramedullary hematopoiesis is rarely recognized in the antemortem setting. We identified 14 patients with renal extramedullary hematopoiesis on antemortem specimens from 1994 to 2015. The mean age was 68 years (range 47-87 years); males predominated (M:F=9:5). All presented with renal insufficiency, including five (36%) with acute kidney injury. The mean serum creatinine at biopsy was 2.9 mg/dl (range 1.2-7.3 mg/dl). All had proteinuria (mean 7.9 g/24 h; range 0.5-28; n=13), including 9 with ≥3 g/24 h...
December 2015: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
Beata Holkova, Adriana Zingone, Maciej Kmieciak, Prithviraj Bose, Ashraf Z Badros, Peter M Voorhees, Rachid Baz, Neha Korde, Hui-Yi Lin, Jin-Qiu Chen, Michelle Herrmann, Liqiang Xi, Mark Raffeld, Xiuhua Zhao, Wen Wan, Mary Beth Tombes, Ellen Shrader, Caryn Weir-Wiggins, Heidi Sankala, Kevin T Hogan, Austin Doyle, Christina M Annunziata, Martha Wellons, John D Roberts, Daniel Sullivan, Ola Landgren, Steven Grant
PURPOSE: AZD6244 is a MEK1/2 inhibitor with significant preclinical activity in multiple myeloma cells. This phase II study used a two-stage Simon design to determine the AZD6244 response rate in patients with relapsed or refractory multiple myeloma. EXPERIMENTAL DESIGN: AZD6244 (75 mg) was administered orally, twice a day, continuously for 28-day cycles. Response was evaluated after three cycles. RESULTS: Thirty-six patients received therapy...
March 1, 2016: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Tânia Santos, Susana Machado, Vítor Sousa, Mário Campos
Renal involvement in Waldenström's macroglobulinaemia (WM) is very unusual when compared to multiple myeloma. We report a case of a patient who developed anuric acute kidney injury secondary to cast nephropathy, dependent on high-flux haemodialysis. Complementary study revealed the presence of blood IgM monoclonal gammopathy and a massive bone marrow lymphoplasmacytic infiltration. There were no osteolytic lesions and no clinical signs/symptoms of hyperviscosity syndrome. The diagnosis of WM was established and a dexamethasone plus cyclophosphamide regime was started, in addition to plasmapheresis...
2015: BMJ Case Reports
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