The reported renal recovery rate of 86% will probably lead to improved patient inhibitor Tofacitinib survival. However, the relative contribution of PE prognosis improvement was not apparent. Therefore, these results should be interpreted with caution. The early decrease in FLC concentrations probably represents efficacy of the chemotherapy rather than that of PE [59, 60].7. Dialysis Therapy in Multiple MyelomaCKD is a common clinical feature of MM. Even with aggressive treatment, progression to ESRD occurs in up to 65% patients with cast nephropathy within 3 months of diagnosis [61]. Treatment-related mortality (29%) and morbidity (3.4%) are higher in patients with CKD than in patients with normal kidney function [15]. The unadjusted median overall survival (OS) on HD was 0.91 years in patients with MM and 4.

46 years in non-MM patients [62]. With a review of the United States Renal Data System, MM-induced CKD is a considerable burden [63]. Of the 375152 patients in the registry who initiated HD for ESRD, 3298 (0.88%) patients had MM. The 2-year all-cause mortality of patients with ESRD due to MM was 58% versus 31% in all other patients (P < 0.01) [63]. MM patients with progressive CKD have a tendency to die within 2�C9 months after the diagnosis [64, 65]. If patients who die within 2 months of diagnosis are excluded, the median survival of patients with MM with ESRD is almost 2 years, and 30% survive for over 3 years [66, 67]. Similarly, another report showed that from 1985 to 2005, 1.5% (2453) of the 159637 patients placed on RRT had MM [34]. The incidence of RRT for ESRD due to MM increased from 0.

70 per million people (1986 to 1990) to 2.52 per million people (2001 to 2005) [34]. Some studies have also indicated that reversibility of kidney dysfunction is associated with improved survival [12, 13, 68]. Even patients who have not been diagnosed with MM at the time HD was initiated for ESRD are at risk of MM for several years, with odds ratios of 3.7, 1.9, 0.9, and 0.8 for 0�C12 months, 12�C25 months, 25�C44 months, and >44 months after starting HD, respectively [69]. According to the recent report, between 0.9 and 1.5% of patients initiating maintenance HD suffer from MM, which may reflect therapeutic success because patients in whom renal function is not completely recovered survive long enough to be chronically dialyzed [62]. Patients with MM and ESRD can be treated either with HD or PD, and both seem to be equally effective Batimastat [7, 70]. Patients who recover their renal function and obtain independence from HD have the same good prognosis as those who never developed AKI. Blade et al. reported that hypercalcemia, degree of renal failure, and amount of proteinuria are factors associated with renal dysfunction in MM-associated CKD patients [12].