PMID- 26728585
OWN - NLM
STAT- MEDLINE
DCOM- 20161213
LR  - 20181113
IS  - 1555-905X (Electronic)
IS  - 1555-9041 (Print)
IS  - 1555-9041 (Linking)
VI  - 11
IP  - 3
DP  - 2016 Mar 7
TI  - Trends in Survival and Renal Recovery in Patients with Multiple Myeloma or 
      Light-Chain Amyloidosis on Chronic Dialysis.
PG  - 431-41
LID - 10.2215/CJN.06290615 [doi]
AB  - BACKGROUND AND OBJECTIVES: Monoclonal gammopathies (MGs) with renal involvement 
      can lead to ESRD caused by myeloma cast nephropathy (MCN), immunoglobulin light 
      chain amyloidosis (ALA), or light-chain deposition disease (LCDD). Few studies 
      have focused on the prognosis of patients with MG on chronic dialysis. We 
      evaluated the outcomes of patients with MG incident on chronic dialysis in 
      France. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: All incident patients 
      registered in the Renal Epidemiology and Information Network Registry between 
      2002 and 2011 with ESRD caused by ALA, LCDD, or MCN were included. Patient's 
      survival, censored for renal transplantation, renal recovery, and loss to 
      follow-up, as well as renal outcomes were analyzed and compared with a control 
      group. Risk factors and causes of death were analyzed. RESULTS: We included 1459 
      patients, comprising 265 (18%) patients with ALA, 334 (23%) patients with LCDD, 
      and 861 (59%) patients with MCN. Median age was 72 years, and 56% were men. 
      Median follow-up was 13.1 months. Renal recovery was observed in 9.1% of patients 
      and more frequent after 2006. Kidney transplantation was rare in this population 
      (2.3%). Among 1272 patients who remained on dialysis, 67% died. Median survival 
      on dialysis was 18.3 months. Main causes of death were malignancies (34.4%), 
      cardiovascular diseases (18%), infections (13.3%), and cachexia (5.2%). 
      Independent risk factors of death were age (hazard ratio [HR], 1.03 per year 
      increase; 95% confidence interval [95% CI], 1.02 to 1.03), frailty (HR, 1.93; 95% 
      CI, 1.58 to 2.36), congestive heart failure (HR, 1.54; 95% CI, 1.23 to 1.93), and 
      dialysis initiation on a central catheter (HR, 1.40; 95% CI, 1.11 to 1.75). 
      Factors associated with a lower risk of death were year of dialysis initiation 
      (HR, 0.95 per year increase; 95% CI, 0.91 to 0.99) and high BP (HR, 0.80; 95% CI, 
      0.67 to 0.97). CONCLUSIONS: Survival of patients with ALA, LCDD, or MCN on 
      chronic dialysis is poor but has improved over time. Progressive malignancy is 
      the main cause of death in this population. Renal recovery has increased since 
      2006.
CI  - Copyright (c) 2016 by the American Society of Nephrology.
FAU - Decourt, Alexandre
AU  - Decourt A
AD  - Departments of *Nephrology.
FAU - Gondouin, Bertrand
AU  - Gondouin B
AD  - Departments of *Nephrology.
FAU - Delaroziere, Jean Christophe
AU  - Delaroziere JC
AD  - Public Health, and.
FAU - Brunet, Philippe
AU  - Brunet P
AD  - Departments of *Nephrology.
FAU - Sallee, Marion
AU  - Sallee M
AD  - Departments of *Nephrology.
FAU - Burtey, Stephane
AU  - Burtey S
AD  - Departments of *Nephrology.
FAU - Dussol, Bertrand
AU  - Dussol B
AD  - Departments of *Nephrology.
FAU - Ivanov, Vadim
AU  - Ivanov V
AD  - Immuno-Hematology, Assistance Publique-Hopitaux de Marseille, Conception 
      Hospital, Aix-Marseille University, Marseille, France; and.
FAU - Costello, Regis
AU  - Costello R
AD  - Immuno-Hematology, Assistance Publique-Hopitaux de Marseille, Conception 
      Hospital, Aix-Marseille University, Marseille, France; and.
FAU - Couchoud, Cecile
AU  - Couchoud C
AD  - French Biomedical Agency, Renal Epidemiology and Information Network Registry, 
      St. Denis, France.
FAU - Jourde-Chiche, Noemie
AU  - Jourde-Chiche N
AD  - Departments of *Nephrology, noemie.jourde@ap-hm.fr.
LA  - eng
PT  - Journal Article
DEP - 20160104
PL  - United States
TA  - Clin J Am Soc Nephrol
JT  - Clinical journal of the American Society of Nephrology : CJASN
JID - 101271570
RN  - 0 (Immunoglobulin Light Chains)
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Amyloidosis/blood/*epidemiology/mortality
MH  - Cause of Death
MH  - Female
MH  - France/epidemiology
MH  - Humans
MH  - Immunoglobulin Light Chains/*blood
MH  - Incidence
MH  - Kaplan-Meier Estimate
MH  - Kidney/*physiopathology
MH  - Kidney Failure, Chronic/epidemiology/mortality/physiopathology/*therapy
MH  - Kidney Transplantation
MH  - Male
MH  - Middle Aged
MH  - Multiple Myeloma/*epidemiology/mortality
MH  - Proportional Hazards Models
MH  - Recovery of Function
MH  - Registries
MH  - *Renal Dialysis/adverse effects/mortality/trends
MH  - Risk Factors
MH  - Time Factors
MH  - Treatment Outcome
PMC - PMC4791812
OTO - NOTNLM
OT  - amyloidosis
OT  - chronic kidney disease
OT  - end stage kidney disease
OT  - humans
OT  - kidney transplantation
OT  - light chain deposition disease
OT  - monoclonal gammopathy
OT  - multiple myeloma
OT  - paraproteinemias
OT  - renal dialysis
EDAT- 2016/01/06 06:00
MHDA- 2016/12/15 06:00
PMCR- 2017/03/07
CRDT- 2016/01/06 06:00
PHST- 2015/06/12 00:00 [received]
PHST- 2015/11/17 00:00 [accepted]
PHST- 2016/01/06 06:00 [entrez]
PHST- 2016/01/06 06:00 [pubmed]
PHST- 2016/12/15 06:00 [medline]
PHST- 2017/03/07 00:00 [pmc-release]
AID - CJN.06290615 [pii]
AID - 06290615 [pii]
AID - 10.2215/CJN.06290615 [doi]
PST - ppublish
SO  - Clin J Am Soc Nephrol. 2016 Mar 7;11(3):431-41. doi: 10.2215/CJN.06290615. Epub 
      2016 Jan 4.