000058458 001__ 58458
000058458 005__ 20210318091405.0
000058458 0247_ $$2doi$$a10.1016/j.nefro.2016.03.011
000058458 0248_ $$2sideral$$a97428
000058458 037__ $$aART-2016-97428
000058458 041__ $$aspa
000058458 100__ $$aBerni Wennekers, A.
000058458 245__ $$aTrece tratamientos de la insuficiencia renal aguda secundaria a mieloma múltiple con filtros de high cut off
000058458 260__ $$c2016
000058458 5060_ $$aAccess copy available to the general public$$fUnrestricted
000058458 5203_ $$aIntroduction Multiple myeloma (MM) is a haematological tumour that is characterised by uncontrolled proliferation of plasma cells and a significant volume of serum free light chains (sFLCs), which can cause acute renal failure due to intratubular precipitation, resulting in cast nephropathy. Acute renal failure is a complication that can arise in more than 20% of patients with multiple myeloma, half of which will require dialysis. Methods We report our experience with 13 patients who were treated with dialysis using high cut off filters (HCO) between July 2011 and February 2015. A total of 6 consecutive 6-hour sessions were performed using a 2.1 m2 HCO filter (Theralite® by Gambro®). Afterwards, further 6-hour sessions were continued on alternate days. Results A total of 151 sessions were conducted, with an average of 11.6 sessions per patient (range 6-27). The treatment proved to be effective in removing both kappa and lambda sFLCs, resulting in a 93.7% fall in sFLCs by the end of treatment. The average reduction was 57.7% per dialysis session. 10 out of the 13 cases recovered sufficient renal function to become independent of dialysis. There were no major changes in albumin levels using an infusion protocol of 2 50-mL vials of 20% albumin at the end of the dialysis session. Conclusions Combination treatment with chemotherapy and long dialysis with HCO filters was effective in reducing the sFLC levels and recovering sufficient renal function in 77% of cases. With HCO filters, significant cost savings are achieved, contrary to what was previously believed.
000058458 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc-nd$$uhttp://creativecommons.org/licenses/by-nc-nd/3.0/es/
000058458 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000058458 700__ $$0(orcid)0000-0002-3668-282X$$aMartín Azara, M.P.$$uUniversidad de Zaragoza
000058458 700__ $$aDourdil Sahun, V.
000058458 700__ $$aBergasa Liberal, B.$$uUniversidad de Zaragoza
000058458 700__ $$0(orcid)0000-0002-4351-8518$$aRuiz Laiglesia, J.E.$$uUniversidad de Zaragoza
000058458 700__ $$aVernet Perna, P.
000058458 700__ $$aAlvarez Lipe, R.
000058458 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000058458 773__ $$g36, 4 (2016), 418-426$$pNefrología (Badalona)$$tNefrologia$$x2013-2514
000058458 8564_ $$s678085$$uhttps://zaguan.unizar.es/record/58458/files/texto_completo.pdf$$yVersión publicada
000058458 8564_ $$s81695$$uhttps://zaguan.unizar.es/record/58458/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000058458 909CO $$ooai:zaguan.unizar.es:58458$$particulos$$pdriver
000058458 951__ $$a2021-03-18-09:09:20
000058458 980__ $$aARTICLE