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Risk Factors and Reversibility of Renal Failure in Patients with Newly Diagnosed Multiple Myeloma
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ȲÇöö(Whang Hyun-Chul) - °¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
°íÀº½Ç(Koh Eun-Sil) - °¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
±èÁ¤°ü(Kim Jeong-Gwan) - °¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
Á¤¼ºÁø(Chung Sung-Jin) - °¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
½Å¼®ÁØ(Shin Seok-Joon) - °¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
¹ÚöÈÖ(Park Cheol-Whee) - °¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
ÀåÀ±½Ä(Chang Yoon-Sik) - °¡Å縯´ëÇб³ ÀÇ°ú´ëÇÐ ³»°úÇб³½Ç
Abstract
¸ñÀû: ½ÅºÎÀüÀº ´Ù¹ß¼º °ñ¼öÁ¾¿¡¼ Á¾Á¾ ¹ß»ýÇÏ¸ç ³ª»Û ¿¹Èĸ¦ º¸ÀδÙ. ¾Æ½Ã¾ÆÀÇ ´Ù¹ß¼º °ñ¼öÁ¾ÀÇ ¹ß»ýºóµµ¿Í Ư¡Àº ¼¾ç°ú´Â ´Ù¸¥ °ÍÀ¸·Î ¾Ë·ÁÁ® ÀÖ´Ù. ÀÌ ¿¬±¸ÀÇ ¸ñÀûÀº ´Ù¹ß¼º °ñ¼öÁ¾ ȯÀڵ鿡¼ ½ÅºÎÀü ¹ß»ýÀÇ À§ÇèÀÎÀÚ ¹× Ä¡·á ÈÄ ½Å±â´É ȸº¹ ÀÎÀÚ¸¦ ã°íÀÚ ÇÏ¿´´Ù.
¹æ¹ý: 2005³âºÎÅÍ 2008³â±îÁö óÀ½ ´Ù¹ß¼º °ñ¼öÁ¾À» Áø´Ü ¹ÞÀº ȯÀÚ¸¦ ´ë»óÀ¸·Î ÇÏ¿© ½ÅºÎÀüÀÇ ¹ß»ý°ú °ü·ÃµÈ ÀÎÀÚ¸¦
Á¶»çÇÏ¿´°í, 12ÁÖ°£ÀÇ Ä¡·á ÈÄ¿¡ ½ÅºÎÀüÀÇ È¸º¹°ú °ü·ÃµÈ ÀÎÀÚ¸¦ ã¾Ò´Ù.
°á°ú: Áø´Ü ´ç½Ã 221¸íÀÇ È¯ÀÚ Áß 86¸í(39%)¿¡¼ ½ÅºÎÀüÀÌ ¹ß»ýÇÏ¿´´Ù. À̺¯·® ·ÎÁö½ºÆ½ ȸ±â ºÐ¼®¿¡¼ ³·Àº Çì¸ð±Û
·Îºó(OR = 0.813, p = 0.02), ³ôÀº º£Å¸-2 ¸¶ÀÌÅ©·Î±Û·ÎºÒ¸°(OR = 1.006, p < 0.01), ACEi (OR = 2.783, p = 0.04) »ç¿ëÀÌ
½ÅºÎÀü ¹ß»ýÀÇ µ¶¸³ÀûÀÎ À§ÇèÀÎÀÚ·Î ³ªÅ¸³µ´Ù. 12ÁÖ°£ÀÇ Ä¡·á ÈÄ, 86¸í Áß¿¡¼ 25 (29%)¸íÀÇ ½Å±â´ÉÀÌ È¸º¹µÇ¾ú´Ù. Ç×¾ÏÄ¡·á¿¡ ¹ÝÀÀÀ» º¸ÀÎ °æ¿ì(OR = 6.044, p < 0.01)¿Í ³ôÀº eGFR (OR = 1.084, p < 0.01)ÀÌ È¸º¹°ú ¿¬°üµÈ ÀÎÀÚ·Î ³ªÅ¸³µ´Ù.
°á·Ð: Çì¸ð±Û·Îºó ¼öÄ¡, º£Å¸-2 ¸¶ÀÌÅ©·Î±Û·ÎºÒ¸°, ACEiÀÇ »ç¿ëÀÌ Çѱ¹ ´Ù¹ß¼º °ñ¼öÁ¾ ȯÀÚ¿¡ ÀÖ¾î ½ÅºÎÀü ¹ß»ýÀÇ
µ¶¸³ÀûÀÎ À§ÇèÀÎÀÚÀ̸ç Ç×¾Ï Ä¡·á¿¡ ¹ÝÀÀ¿©ºÎ¿Í Áø´Ü ½ÃÀÇ eGFRÀÌ ½Å±â´É ȸº¹ÀÇ ¿¹ÃøÀÎÀÚÀÌ´Ù.
Background/Aims: Multiple myeloma (MM) is frequently accompanied by renal insufficiency, which has been regarded as a poor prognostic factor for MM. It is known that the incidence and characteristics of MM in Asia differ from those in Western countries. The aim of this study was to evaluate risk factors for renal impairment and to investigate reversible factors for renal failure in patients with MM.
Methods: Patients newly diagnosed with MM from 2005 to 2008 were included. We investigated factors associated with renal insufficiency and those related to recovery from renal dysfunction after 12 weeks of treatment of MM.
Results: Renal failure was recognized in 86 (39%) of 221 patients at diagnosis. In the binary logistic regression analysis, low hemoglobin (odds ratio [OR], 0.813; p = 0.02), high ¥â2microglobulin (OR, 1.006; p < 0.01), and use of angiotensin-converting enzyme inhibitors (ACEi) (OR, 2.783; p < 0.04) at initial presentation were independent risk factors for renal failure in patients with multiple myeloma. After 12 weeks of treatment, 25 of 86 (29%) patients with renal failure had recovered renal function. Good response to chemotherapy (OR, 6.044; p < 0.01) and higher eGFR (OR, 1.084; p < 0.01) were associated with renal function recovery.
Conclusions: Levels of hemoglobin and ¥â2microglobulin, and use of ACEi were independent risk factors for the development of renal failure in MM patients. The response to chemotherapy and eGFR at diagnosis significantly influenced recovery of renal function.
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´Ù¹ß¼º °ñ¼öÁ¾, ½ÅºÎÀü, À§ÇèÀÎÀÚ
Multiple myeloma, Renal insufficiency, Risk factors
KMID :
0882420140860020190
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