Clinical and prognostic differences among patients with light chain deposition disease, myeloma cast nephropathy and both
Clinical and prognostic differences among patients with light chain deposition disease, myeloma cast nephropathy and both
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DOI：
10.3109/10428194.2015.1040011
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发表时间：
2015-12-02
影响因子：
2.6
通讯作者：
Leung, Nelson
中科院分区：
文献类型：
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作者：
Zand, Ladan;Nasr, Samih H.;Leung, Nelson
在一些轻链沉积病（LCDD）患者中，肾活检也有骨髓瘤管型肾病（MCN）的证据。本研究的目的是评估合并诊断MCN和LCDD的患者与单独诊断LCDD和MCN的患者的肾脏和生存结局。87例患者被确定并分为LCDD（n = 45），MCN（n = 29）和LCDD+ MCN（n = 13）。与LCDD患者相比，LCDD+ MCN患者的总生存期（OS）较差（p = 0.03），但与MCN患者相似（p = 0.4）。各组之间的死亡删失肾脏存活率无差异。肾活检时出现急性肾衰竭（HR 7.2，p = 0.0002）是一个独立的肾脏预后不良因素，而年龄较大（HR 1.06，p = 0.0002），存在溶骨性病变（HR 4.4，p < 0.0001）和肾活检时需要透析或肌酐>= 5 mg/dL（HR 3.2，p = 0.0006）是OS的独立不良预后因素。
In some patients with light chain deposition disease (LCDD) there is also evidence of myeloma cast nephropathy (MCN) on renal biopsy. The purpose of this study was to evaluate the renal and survival outcome of patients with concomitant diagnosis of MCN and LCDD to LCDD and MCN alone. Eighty seven patients were identified and divided into LCDD (n = 45), MCN (n = 29), and LCDD+ MCN (n = 13). Patients with LCDD+ MCN had a worse overall survival (OS) compared to patients with LCDD (p = 0.03), but similar to patients with MCN (p = 0.4). Death-censored renal survival was no different amongst the groups. Presenting with acute renal failure at time of renal biopsy (HR 7.2, p = 0.0002) was an independent poor renal prognostic factor while older age (HR 1.06, p = 0.0002), presence of osteolytic lesions (HR 4.4, p < 0.0001), and requirement for dialysis or creatinine >= 5 mg/dL (HR 3.2, p = 0.0006) at time of renal biopsy were independent poor prognostic factors for OS.