Glomerular diseases associated with multiple myeloma: renal pathology and survival outcomes in a retrospective study at Charles Nicolle Hospital, Tunis, Tunisia.
- 1Department of Internal Medicine A, Charles Nicolle Hospital, Tunis, Tunisia.
- 2Laboratory of Renal Pathology LR00SP01, Charles Nicolle Hospital, Tunis, Tunisia.
- 3Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.
Abstract
Multiple myeloma (MM) is frequently complicated by renal involvement, which represents a major prognostic factor included in the Durie-Salmon staging system. In contrast, glomerular diseases associated with MM are rare and have been reported mainly in small case series. This study aimed to describe the clinical and histopathological characteristics of MM-associated glomerular diseases and to identify factors associated with renal and overall survival. we conducted a retrospective hospital-based study over 33 years, including patients with MM and biopsy-proven glomerular disease. Clinical, biological, and histopathological data were collected. Renal and overall survival were analysed using Kaplan-Meier methods and multivariable Cox regression analysis. Factors associated with the presence of glomerular disease were assessed using multivariable logistic regression, by comparison with patients with MM without renal involvement. a total of 22 patients (100%, n=22) with MM-associated glomerular disease were included. The mean age was 55.5 ± X years, and males represented Y% (n=Z). Proteinuria was present in 86.4% (n=19) and hematuria in 63.6% (n=14). The mean creatinine clearance was 25.6 ± 28.3 mL/min, and renal impairment was observed in 72.7% (n=16). According to the Durie-Salmon classification, 13.6% (n=3) were stage I, 22.7% (n=5) stage II, and 63.6% (n=14) stage III. Histopathological findings showed amyloidosis in 72.7% (n=16), monoclonal immunoglobulin deposition disease in 22.7% (n=5), and membranous glomerulonephritis in 4.5% (n=1). Renal survival at 12 months was 54% (n=12). In multivariable Cox regression analysis, independent predictors of worse renal survival were smoking (aHR: 3.10, 95% CI 1.30-7.40; p=0.01), baseline renal impairment (serum creatinine >177 μmol/L) (aHR: 2.85, 95% CI 1.20-6.80; p=0.02), plasma uric acid >600 µmol/L (aHR: 3.95, 95% CI 1.60-9.70; p=0.003), and disease progression despite therapy (aHR: 2.70, 95% CI 1.15-6.30; p=0.02). For overall survival, serum calcium >2.8 mmol/L (aHR: 4.20, 95% CI 1.70-10.3; p=0.002), serum phosphorus >2 mmol/L (aHR: 3.80, 95% CI 1.60-9.00; p=0.001), and Durie-Salmon stage III (aHR: 2.40, 95% CI 1.10-5.40; p=0.03) remained independently associated with mortality. Compared with patients with MM without renal involvement, multivariable logistic regression showed that proteinuria (aOR: 5.10, 95% CI 1.10-23.5; p=0.04), elevated alkaline phosphatase (aOR: 4.30, 95% CI 1.30-14.2; p=0.02), and absence of IgG-kappa MM (aOR: 3.90, 95% CI 1.20-12.8; p=0.02) were independently associated with glomerular involvement. in this retrospective study, glomerular diseases associated with MM were uncommon and predominantly represented by amyloidosis. Renal and overall survival were poor and were independently influenced by renal function, metabolic abnormalities, and advanced disease stage.
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BibTeX
@article{hajji2026glomerular,
title = {{Glomerular diseases associated with multiple myeloma: renal pathology and survival outcomes in a retrospective study at Charles Nicolle Hospital, Tunis, Tunisia.}},
author = {Meriam Hajji and Samia Barbouch and Seif Azaiez and Hayet Kaaroud and Rym Goucha and Fethi Ben Hamida and Amel Harzallah and Ezzeddine Abderrahim},
journal = {The Pan African medical journal},
year = {2026},
month = jun,
doi = {10.11604/pamj.2026.54.35.38464},
url = {https://europepmc.org/article/MED/42952767},
note = {CC BY},
}
RIS
TY - JOUR
TI - Glomerular diseases associated with multiple myeloma: renal pathology and survival outcomes in a retrospective study at Charles Nicolle Hospital, Tunis, Tunisia.
AU - Meriam Hajji
AU - Samia Barbouch
AU - Seif Azaiez
AU - Hayet Kaaroud
AU - Rym Goucha
AU - Fethi Ben Hamida
AU - Amel Harzallah
AU - Ezzeddine Abderrahim
PY - 2026
DA - 2026/06/08
JO - The Pan African medical journal
DO - 10.11604/pamj.2026.54.35.38464
UR - https://europepmc.org/article/MED/42952767
AB - Multiple myeloma (MM) is frequently complicated by renal involvement, which represents a major prognostic factor included in the Durie-Salmon staging system. In contrast, glomerular diseases associated with MM are rare and have been reported mainly in small case series. This study aimed to describe the clinical and histopathological characteristics of MM-associated glomerular diseases and to identify factors associated with renal and overall survival. we conducted a retrospective hospital-based study over 33 years, including patients with MM and biopsy-proven glomerular disease. Clinical, biological, and histopathological data were collected. Renal and overall survival were analysed using Kaplan-Meier methods and multivariable Cox regression analysis. Factors associated with the presence of glomerular disease were assessed using multivariable logistic regression, by comparison with patients with MM without renal involvement. a total of 22 patients (100%, n=22) with MM-associated glomerular disease were included. The mean age was 55.5 ± X years, and males represented Y% (n=Z). Proteinuria was present in 86.4% (n=19) and hematuria in 63.6% (n=14). The mean creatinine clearance was 25.6 ± 28.3 mL/min, and renal impairment was observed in 72.7% (n=16). According to the Durie-Salmon classification, 13.6% (n=3) were stage I, 22.7% (n=5) stage II, and 63.6% (n=14) stage III. Histopathological findings showed amyloidosis in 72.7% (n=16), monoclonal immunoglobulin deposition disease in 22.7% (n=5), and membranous glomerulonephritis in 4.5% (n=1). Renal survival at 12 months was 54% (n=12). In multivariable Cox regression analysis, independent predictors of worse renal survival were smoking (aHR: 3.10, 95% CI 1.30-7.40; p=0.01), baseline renal impairment (serum creatinine >177 μmol/L) (aHR: 2.85, 95% CI 1.20-6.80; p=0.02), plasma uric acid >600 µmol/L (aHR: 3.95, 95% CI 1.60-9.70; p=0.003), and disease progression despite therapy (aHR: 2.70, 95% CI 1.15-6.30; p=0.02). For overall survival, serum calcium >2.8 mmol/L (aHR: 4.20, 95% CI 1.70-10.3; p=0.002), serum phosphorus >2 mmol/L (aHR: 3.80, 95% CI 1.60-9.00; p=0.001), and Durie-Salmon stage III (aHR: 2.40, 95% CI 1.10-5.40; p=0.03) remained independently associated with mortality. Compared with patients with MM without renal involvement, multivariable logistic regression showed that proteinuria (aOR: 5.10, 95% CI 1.10-23.5; p=0.04), elevated alkaline phosphatase (aOR: 4.30, 95% CI 1.30-14.2; p=0.02), and absence of IgG-kappa MM (aOR: 3.90, 95% CI 1.20-12.8; p=0.02) were independently associated with glomerular involvement. in this retrospective study, glomerular diseases associated with MM were uncommon and predominantly represented by amyloidosis. Renal and overall survival were poor and were independently influenced by renal function, metabolic abnormalities, and advanced disease stage.
SN - 1937-8688
ER -