title: Renal Insufficiency in newly-diagnosed multiple myeloma: analysis according to International Myeloma Working Group consensus statement.
abstract: Renal impairment (RI) is one of the key clinical manifestations of symptomatic multiple myeloma. However, the incidence of RI and renal response to treatment are variable depending on their definition. A total of 379 patients newly-diagnosed and treated for symptomatic myeloma at the Samsung Medical Center between January 2000 and December 2011 were retrospectively reviewed. RI and renal response were assessed according to the recent International working group (IMWG) recommendations. Out of the 379 patients, renal insufficiency was present in 117 (30.8%) and was associated with adverse clinical parameters such as anemia, elevated beta-2 microglobulin (B2M), elevated lactate dehydrogenase (LDH), hypercalcemia, and more advanced disease by the International Staging System (ISS). Out of the 85 patients who were evaluable for renal response, 58 (68.2%) showed renal response and 46 (54%) had major renal response. Less advanced disease by the International Staging System and inclusion of high-dose dexamethasone as first-line treatment were independently predictive for major renal response. Median time-to-renal response was 5.5 months, and bortezomib-containing regimen, high-dose dexamethasone, and less advanced stage disease were associated with a more rapid renal response.
  
  
  CONCLUSIONS
  The incidence of RI in patients with newly-diagnosed multiple myeloma was 31%, and renal response was affected by the treatment and staging by the International Staging System.
authors: Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors: Silvia
authors: S
authors: Park
authors: Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea.
authors: Boram
authors: B
authors: Han
authors: Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea kihyunkimk@gmail.com.
authors: Kihyun
authors: K
authors: Kim
authors: Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors: Seok Jin
authors: SJ
authors: Kim
authors: Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors: Jun Ho
authors: JH
authors: Jang
authors: Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors: Won Seog
authors: WS
authors: Kim
authors: Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors: Chul Won
authors: CW
authors: Jung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000401:mortality / Q000503:physiopathology; D011379:Prognosis; D051437:Renal Insufficiency / Q000453:epidemiology*; D012189:Retrospective Studies
keywords: Myeloma; renal impairment; renal response