The effect of multiple myeloma therapy on the restoration of renal function
Savuliak G.R.1, Maksymets T.A.2, Sklyarov Ya.E.2
- 1State Institution «Institute of Blood Pathology and Transfusion Medicine NAMS of Ukraine», Lviv, Ukraine
- 2Nonprofit Organization «Danylo Halytskyi National Medical University», Lviv, Ukraine
Summary. Aim. To investigate the functional status of the kidneys in patients with newly diagnosed multiple myeloma (ММ) and to compare it with patients who have received treatment. Object and methods of study. The study included 95 patients with MM, divided into two groups: 27 patients with newly diagnosed MM (Group 1) and 68 patients who had received MM treatment, achieving a partial or complete response (Group 2). All patients underwent general clinical and laboratory tests, including the determination of serum neutrophil gelatinase-associated lipocalin (NGAL) and fibroblast growth factor 23 (FGF-23) levels by ELISA. Glomerular filtration rate (GFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula according to Kidney Disease: Improving Global Outcomes (KDIGO) 2024 recommendations. For statistical analysis, Student’s t-test, Mann — Whitney U-test, and Fisher’s exact test were used. Results. In patients who received treatment (Group 2), a significant reduction in tumor burden was observed, confirmed by a statistically significant decrease in M-protein and β₂-microglobulin levels. This led to an effective correction of anemic syndrome and a reduction in systemic inflammation. Regarding renal function, this group showed a significant decrease in serum creatinine (p=0.0191) and an improvement in GFR (p=0.0261). A particularly important finding was a significant decrease in serum NGAL concentration (p=0.0025) in patients after treatment (178.33 pg/ml) compared to patients with newly diagnosed MM (197.72 pg/ml). This indicates the recovery of not only glomerular but also tubular kidney function. While there was a noticeable trend towards a decrease in FGF-23 levels in the post-treatment group, it did not reach statistical significance. Conclusions. Modern anti-myeloma therapy effectively reduces tumor burden and promotes the recovery of kidney function. The decrease in NGAL levels confirms that the therapeutic effect extends not only to the glomerular apparatus but also to the recovery of renal tubular function. The use of NGAL in combination with traditional markers provides a more complete picture of the kidney’s condition in multiple myeloma.
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