CLINICAL AND LABORATORY DIFFERENCES IN PATIENTS WITH MULTIPLE MYELOMA DEPENDING ON RENAL FUNCTION
DOI:
https://doi.org/10.11603/1811-2471.2025.v.i3.15561Keywords:
multiple myeloma, glomerular filtration rate, anemia, renal dysfunction, β2-microglobulinAbstract
SUMMARY. Multiple myeloma (MM) is a malignant hematological disease characterized by clonal proliferation of pathological plasma cells in the bone marrow and excessive production of monoclonal immunoglobulin, known as M-gradient. The disease most commonly manifests as anemia, recurrent infections, and osteolytic lesions of the skeletal bones, which in turn leads to impaired function of organs and systems. Kidneys are often affected due to the deposition of light chains of immunoglobulins, hypercalcemia, or infiltration of kidney tissue by tumor cells.
The aim – to compare the frequency of clinical manifestations and laboratory parameters of patients with MM and renal dysfunction (RD).
Material and Methods. The study involved 105 patients with MM. Patients were divided according to their renal functional status, with the presence of renal dysfunction verified by the glomerular filtration rate (GFR): Group 1 – 80 patients with GFR > 60 mL/min/1.73m2 and Group 2 – 25 patients with GFR<60 mL/min/1.73m2. All patients underwent thorough collection of medical history and anamnesis, general clinical examinations, and laboratory tests. Comparison of the two groups was performed using the Mann-Whitney U test. Relative values were presented as percentages, and groups were compared using Pearson's chi-squared test. The significance level was set at p<0.05.
Results. The study revealed that patients with MM and impaired renal function had a significantly higher incidence of dyspnea (56.0 % vs. 22.5 %, p<0.05) and diarrhea (72.0 % vs. 43.8 %, p<0.05) compared to patients without renal dysfunction (RD). In addition, this group of patients showed changes in laboratory parameters, including signs of anemia, elevated markers of inflammation, and impaired renal function. Specifically, patients with RD had lower levels of hemoglobin and albumin, as well as higher levels of β2-microglobulin, creatinine, and urea.
Conclusions.The study clearly demonstrates that a decrease in GFR in patients with MM is associated with a worsening of the clinical picture, changes in blood parameters reflecting anemia and inflammation, and significant impairment of renal function, confirmed by changes in biochemical markers.
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