Multiple myeloma patients on chronic dialysis in Uruguay: analysis of the last 40 years

María B. Canzani, Centro de Nefrología, Hospital de Clínicas UDELAR; Servicio de Nefrología, Hospital Pasteur; Montevideo, Uruguay
Eloísa Riva, Cátedra de Hematología, Hospital de Clínicas UDELAR, Montevideo, Uruguay
Alejandro Ferreiro, Centro de Nefrología, Hospital de Clínicas UDELAR, Montevideo, Uruguay
María C. González-Bedat, Registro Uruguayo de Diálisis, Sociedad Uruguaya de Nefrología, Montevideo, Uruguay
Leonella Luzardo, Centro de Nefrología, Hospital de Clínicas UDELAR;; Registro Uruguayo de Diálisis, Sociedad Uruguaya de Nefrología. Montevideo, Uruguay

Objective: To analyze the clinical presentation, evolution and prognosis of patients admitted to chronic dialysis in Uruguay between 1981 and 2020 with multiple myeloma associated nephropathies. Material and methods: This is a descriptive and retrospective study, based on the Uruguayan Dialysis Registry, the Glomerulopathies Prevention and Treatment Program, and the data from state office that finances treatment. We performed an analysis based on whether or not the patient had received treatment with bortezomib, which became available in Uruguay in 2010. Results: We analyzed 287 patients with a mean age of 65.1 ± 12.1 years, 92.3% of whom started hemodialysis. 24.4% of patients had a renal biopsy, with amyloidosis being the most frequent diagnosis. The survival of the entire population was 29 months (IQR: 14-37). We observed an increase in the incidence rate of patients with multiple myeloma, which went from 0.55 pmp in the first five-year period analyzed (1981-1984) to 3.77 pmp in the last period (2015-2020). The survival of patients who received the drug was higher (41 months; 95%CI: 31-52) than that of those who did not (26 months; 95%CI: 21-32) (p = 0.014). Conclusions: Patients treated with bortezomibhad a higher survival rate, which was surely contributed to by the improvement in nephrological and hematological care inrecent years.

Keywords: Multiple myeloma. Chronic dialysis. Survival. Bortezomib.