Analysis of related risk factors and reversal value of renal injury in elderly patients with multiple myeloma.

PURPOSE To study risk factors associated with renal injuries in elderly patients with multiple myeloma. METHODS From January 2012 to January 2015 135 elderly patients with multiple myeloma who were treated in Xuzhou No.1 People's Hospital were enrolled in this study. Risk factors associated with their renal function, such as gender, serum levels of hemoglobin, uric acid, serum calcium and phosphorus, serum and urinary levels of β2 microglobulin, diastolic blood pressure and light chain protein distribution were assessed before and after relative treatments. RESULTS Compared with patients with normal renal function, the proportion of severe anemia, serum uric acid, calcium, and phosphorus levels were significantly higher in patients with abnormal renal function. Also, serum and urinary β2 microglobulin levels and diastolic blood pressure were significantly higher in patients with abnormal renal function. Light chain protein of patients with abnormal renal function (mostly λ protein), severe anemia, abnormally increased calcium and high diastolic blood pressure were independent risk factors in renal injuries. Blood urea nitrogen (BUN) and creatinine levels in both groups returned to normal after the anemia was corrected. Compared with the abnormal renal function group, one-year survival rate in the normal renal function group with myeloma was significantly higher. CONCLUSION Increased diastolic blood pressure, moderate and severe anemia as well as elevated level of serum calcium were independent risk factors for renal injuries in multiple myeloma. Blood pressure control (especially diastolic blood pressure) and correcting the anemia were proved to be effective means for reversing the disturbed renal function and ameliorating patients' quality of life .