[Efficacy of SUPRA HFR in the treatment of acute renal damage during multiple myeloma]

G Ital Nefrol. 2018 Dec;35(6):2018-vol6.
[Article in Italian]

Abstract

Acute Kidney Injury (AKI) is a frequent complication of multiple myeloma (MM) with unfavorable prognostic significance. Light chains removal, combined with hematological therapy (CT) seems to offer significant benefits to renal function recovery (RFR). The SUPRA HFR, through the combination of high cut-off membrane without albumin loss and adsorbent cartridge, represents one of the "emerging" light chain removal methods. We report our multicentric retrospective experience with SUPRA HFR in 7 MM patients. At the end of the treatment with SUPRA HFR a significant reduction in serum free light chains compared to baseline was observed (min 24%; max 90%; median 74%). Despite a not always early start of the treatment, all patients recovered renal function with withdrawal from dialysis in 6/7 cases. Our preliminary experience of a combination of SUPRA HFR treatment with CT in 7 MM patients with AKI showed a significative renale functional recovery, with favourable cost/benefit ratio and a simple treatment schedule. These encouraging data suggest to further extend such treatment option, waiting for larger studies in this field.

Keywords: AKI; Acute kidney injury; haemodiafiltration; multiple myeloma.

Publication types

  • Evaluation Study

MeSH terms

  • Acute Kidney Injury / etiology
  • Acute Kidney Injury / therapy*
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Combined Modality Therapy
  • Female
  • Hemodiafiltration / methods*
  • Humans
  • Immunoglobulin Light Chains / metabolism
  • Male
  • Middle Aged
  • Multiple Myeloma / complications*
  • Multiple Myeloma / drug therapy
  • Myeloma Proteins / metabolism
  • Plasmapheresis
  • Treatment Outcome

Substances

  • Immunoglobulin Light Chains
  • Myeloma Proteins