Long Hemodialysis Treatment with High Cut Off Membranes in Patients with Acute Kidney Injury Secondary to Multiple Myeloma: Case Presentations

Shterjova-Markovska Z, Rambabova-Bushljetik I, Severova G, Nikolov I, Trajcevska L, Karanfilovski V, Sulejman S, Balkanov S and Spasovski G
 

University Clinic of Nephrology, Un. Ss Cyril and Methodius, Skopje, N. Macedonia
University Clinic of Hematology, Un. Ss Cyril and Methodius, Skopje, N. Macedonia

^*Correspondance to: Zhaklina Shterjova Markovska 

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Abstract:

Introduction: Multiple Myeloma (MM) as a malignant proliferation of plasma cells in the bone marrow, with an excessive release of serum Free Light Chains (FLC) can be associated with Acute Kidney Injury (AKI). The key to treating AKI is rapid FLC reduction using newer chemotherapeutic agents, such as bortezomib and extracorporeal removal of FLC by using a High Cut Off membranes (HCO) with high permeability and molecular weight cut-off pore size (45-60 kD) for Hemodialysis (HD). Case Series: We report on four cases with MM who developed AKI and were treated with HCO-HD and specific chemotherapy with bortezomib on our clinic. Initially, 7-h sessions were performed using a 2.1 m2 HCO filter. Then, it was continued alternately every other day with additional sessions of 8 h. Results: The mean Reduction Ratio (mRR) of kFLC of the first patient was 49%, 45.5%, mRR of λFLC of the second, 49% of the third, and 60% of the fourth patient, respectively, with the mean value of 50.8%. In the two cases with λFLC the mRR was 52.75% (range 45.5-60%), and in the two other cases with kFLC, the mRR was 49% (with no range variety). Three out of four patients sufficiently recovered the renal function becoming independent of HD. Conclusion: The combined treatments of chemotherapy plus long HCO-HD sessions are effective in reducing the levels of FLC and sufficiently recovering renal function, allowing significant savings, better quality of life and longer life span.

Keywords:

Acute kidney injury; Multiple myeloma; High-cut off membrane dialysis

Cite the Article:

Shterjova-Markovska Z, Rambabova- Bushljetik I, Severova G, Nikolov I, Trajcevska L, Karanfilovski V, et al. Long Hemodialysis Treatment with High Cut Off Membranes in Patients with Acute Kidney Injury Secondary to Multiple Myeloma: Case Presentations. Clin Case Rep Int. 2024; 8: 1699.