TITLE

COMPARATIVE ANALYSIS OF THE EFFECT OF ADDITIONAL THERAPEUTIC MEASURES ON RENAL RECOVERY IN PATIENTS OF MULTIPLE MYELOMA ASSOCIATED CAST NEPHROPATHY PRESENTING WITH DIALYSIS REQUIRING ACUTE RENAL FAILURE

AUTHOR(S)
Das, Pratik
PUB. DATE
July 2007
SOURCE
Indian Journal of Nephrology;Jul-Sep2007, Vol. 17 Issue 3, p128
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Aim: To evaluate the effect of high flux dialysis and plasma pheresis on renal recovery of myeloma cast nephropathy and to compare them with conventional low flux dialysis Materials and Methods: 16 patients of light chain myeloma with cast nephropathy and ARF were divided into three groups. Group I consisting of 6 patients received HD 3 per week with high flux polysulphone dialyser, Group II consisting of 6 patients received 3 per week HD with conventional F6 polysulphone dialyser and Group III consisting of 4 patients received 3 per week HD using F6 polysulphone dialyser combined with alternate day plasma exchange. All three groups received VAD based chemo therapy. Demographic profiles and comorbidities are similar in all the three groups. Reassessment in terms of dialysis requirement, serum creatinine and light chain level were evaluated at 4,8 and 12 weeks. Comparative analysis was done in between the groups. Resutls: In Group I, 1 patient at 4 weeks, 3 patients at 8 weeks and all 6 patients at 12 weeks became dialysis independent with mean creatinine of 2.1 mg/dl at 12 weeks. In Group II, none at 4 weeks, 1 at 8 weeks and only 3 at 12 weeks became dialysis independent and the mean creatinine of all the patients were 5.6 mg/dl at 12 weeks. In Group III, 1 patient died at 4 weeks, plasma exchange stopped at 4 weeks in 2 patients (due to financial reasons), they became dialysis independent at 12 weeks, 1 patient became dialysis independent at 8 weeks and plasma exchange discontinued. Mean creatinine at 12 weeks was 2.2 mg/dl. Cost of therapy was much higher in Group III. Conclusion: Use of high flux dialyser enhances light chain removal and tumour burden and there by enhances renal recovery in myeloma cast nephropathy compared to conventional dialysis using F6 polysulphone dialyser with or without plasma exchange.
ACCESSION #
29964730

 

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