The Role of High-Risk Cytogenetics in Acute Kidney Injury of Newly Diagnosed Multiple Myeloma: A Cohort Study

Branco, Carolina; Silva, Manuel; Rodrigues, Natacha; Vieira, Joana; Forjaz Lacerda, João; Lopes, José António

doi:10.3390/ijms26136108

Open AccessArticle

The Role of High-Risk Cytogenetics in Acute Kidney Injury of Newly Diagnosed Multiple Myeloma: A Cohort Study

by

Carolina Branco

^1,†

,

Manuel Silva

^1,†,

Natacha Rodrigues

^1,2,

Joana Vieira

³

,

João Forjaz Lacerda

^2,3,4 and

José António Lopes

^1,2,*

¹

Division of Nephrology and Renal Transplantation, Unidade Local de Saúde Santa Maria, 1649-035 Lisbon, Portugal

²

Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal

³

Division of Hematology, Unidade Local de Saúde Santa Maria, 1649-035 Lisbon, Portugal

⁴

Gulbenkian Institute for Molecular Medicine (GIMM), 1649-028 Lisbon, Portugal

^*

Author to whom correspondence should be addressed.

^†

These authors contributed equally to this work.

Int. J. Mol. Sci. 2025, 26(13), 6108; https://doi.org/10.3390/ijms26136108

Submission received: 8 May 2025 / Revised: 13 June 2025 / Accepted: 23 June 2025 / Published: 25 June 2025

(This article belongs to the Special Issue Analysis on Effector and Regulatory Molecules in Renal Diseases)

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Abstract

Multiple myeloma (MM) is frequently associated with cytogenetic abnormalities, with high-risk cytogenetics linked to poorer survival. Acute kidney injury (AKI) is common in MM, but its relationship with high-risk cytogenetics remains underexplored. This study aimed to assess the association between high-risk cytogenetics and AKI in newly diagnosed MM patients and to evaluate their impact on overall survival, relapse-free survival, and progression to chronic kidney disease (CKD) in the first two years after diagnosis. We conducted a single-center retrospective cohort study including patients newly diagnosed with MM between 2018 and 2022. We enrolled 122 patients. AKI was observed in 36.9% of patients, rising to 62.3% among those with high-risk cytogenetics. High-risk cytogenetics (OR: 3.32; 95% CI: 1.17–6.40; p = 0.024), CKD (OR: 9.14; 95% CI: 2.92–18.65; p < 0.001), kappa free light chains, hypercalcemia, difference in free light chain (dFLC), and bone marrow plasmocyte percentage were independently associated with AKI. Both AKI (HR: 2.71; 95% CI: 1.18–6.23; p = 0.019) and high-risk cytogenetics (HR: 3.33; 95% CI: 1.13–9.76; p = 0.029) were independently associated with lower overall survival. Among survivors without prior CKD, progression to CKD was higher in those with AKI (30.7% vs. 9.3%; p = 0.041). High-risk cytogenetics were significantly associated with AKI in MM patients. Both factors independently predict worse survival and increased risk of CKD progression.

Keywords: high-risk cytogenetics; acute kidney injury; multiple myeloma; epidemiology

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MDPI and ACS Style

Branco, C.; Silva, M.; Rodrigues, N.; Vieira, J.; Forjaz Lacerda, J.; Lopes, J.A. The Role of High-Risk Cytogenetics in Acute Kidney Injury of Newly Diagnosed Multiple Myeloma: A Cohort Study. Int. J. Mol. Sci. 2025, 26, 6108. https://doi.org/10.3390/ijms26136108

AMA Style

Branco C, Silva M, Rodrigues N, Vieira J, Forjaz Lacerda J, Lopes JA. The Role of High-Risk Cytogenetics in Acute Kidney Injury of Newly Diagnosed Multiple Myeloma: A Cohort Study. International Journal of Molecular Sciences. 2025; 26(13):6108. https://doi.org/10.3390/ijms26136108

Chicago/Turabian Style

Branco, Carolina, Manuel Silva, Natacha Rodrigues, Joana Vieira, João Forjaz Lacerda, and José António Lopes. 2025. "The Role of High-Risk Cytogenetics in Acute Kidney Injury of Newly Diagnosed Multiple Myeloma: A Cohort Study" International Journal of Molecular Sciences 26, no. 13: 6108. https://doi.org/10.3390/ijms26136108

APA Style

Branco, C., Silva, M., Rodrigues, N., Vieira, J., Forjaz Lacerda, J., & Lopes, J. A. (2025). The Role of High-Risk Cytogenetics in Acute Kidney Injury of Newly Diagnosed Multiple Myeloma: A Cohort Study. International Journal of Molecular Sciences, 26(13), 6108. https://doi.org/10.3390/ijms26136108

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The Role of High-Risk Cytogenetics in Acute Kidney Injury of Newly Diagnosed Multiple Myeloma: A Cohort Study

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