title: Clinical and prognostic differences among patients with light chain deposition disease, myeloma cast nephropathy and both.
abstract: In some patients with light chain deposition disease (LCDD) there is also evidence of myeloma cast nephropathy (MCN) on renal biopsy. The purpose of this study was to evaluate the renal and survival outcome of patients with concomitant diagnosis of MCN and LCDD to LCDD and MCN alone. Eighty seven patients were identified and divided into LCDD (n=45), MCN (n=29), and LCDD+ MCN (n=13). Patients with LCDD+ MCN had a worse overall survival (OS) compared to patients with LCDD (p=0.03), but similar to patients with MCN (p=0.4). Death-censored renal survival was no different amongst the groups. Presenting with acute renal failure at time of renal biopsy (HR 7.2, p=0.0002) was an independent poor renal prognostic factor while older age (HR 1.06, p=0.0002), presence of osteolytic lesions (HR 4.4, p<0.0001), and requirement for dialysis or creatinine≥5 mg/dL (HR 3.2, p=0.0006) at time of renal biopsy were independent poor prognostic factors for OS.
authors: a Division of Nephrology and Hypertension , Rochester , MN , USA.
authors: Ladan
authors: L
authors: Zand
authors: b Department of Laboratory Medicine and Pathology , Rochester , MN , USA.
authors: Samih H
authors: SH
authors: Nasr
authors: c Division of Hematology, Mayo Clinic , Rochester , MN , USA.
authors: Morie A
authors: MA
authors: Gertz
authors: c Division of Hematology, Mayo Clinic , Rochester , MN , USA.
authors: Angela
authors: A
authors: Dispenzieri
authors: c Division of Hematology, Mayo Clinic , Rochester , MN , USA.
authors: Martha Q
authors: MQ
authors: Lacy
authors: c Division of Hematology, Mayo Clinic , Rochester , MN , USA.
authors: Francis K
authors: FK
authors: Buadi
authors: c Division of Hematology, Mayo Clinic , Rochester , MN , USA.
authors: Shaji
authors: S
authors: Kumar
authors: c Division of Hematology, Mayo Clinic , Rochester , MN , USA.
authors: Robert A
authors: RA
authors: Kyle
authors: a Division of Nephrology and Hypertension , Rochester , MN , USA.
authors: Fernando C
authors: FC
authors: Fervenza
authors: b Department of Laboratory Medicine and Pathology , Rochester , MN , USA.
authors: Sanjeev
authors: S
authors: Sethi
authors: b Department of Laboratory Medicine and Pathology , Rochester , MN , USA.
authors: David
authors: D
authors: Dingli
authors: b Department of Laboratory Medicine and Pathology , Rochester , MN , USA.
authors: S Vincent
authors: SV
authors: Rajkumar
authors: c Division of Hematology, Mayo Clinic , Rochester , MN , USA.
authors: Prashant
authors: P
authors: Kapoor
authors: c Division of Hematology, Mayo Clinic , Rochester , MN , USA.
authors: Arleigh
authors: A
authors: McCurdy
authors: a Division of Nephrology and Hypertension , Rochester , MN , USA.|c Division of Hematology, Mayo Clinic , Rochester , MN , USA.
authors: Nelson
authors: N
authors: Leung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017772:Amyloid Neuropathies / Q000175:diagnosis* / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D001706:Biopsy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000378:metabolism*; D007668:Kidney / Q000378:metabolism / Q000473:pathology / Q000648:ultrastructure; D007674:Kidney Diseases / Q000175:diagnosis* / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D007686:Kidney Tubules, Distal / Q000378:metabolism / Q000473:pathology / Q000648:ultrastructure; D008297:Male; D008856:Microscopy, Fluorescence; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications*; D011379:Prognosis; D016016:Proportional Hazards Models; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D007147:Immunoglobulin Light Chains
keywords: Light chain deposition disease; multiple myeloma; myeloma cast nephropathy; renal disease