Clinical Study and Analysis of Kidney Disease in Patients with Hematological Malignancies

ABSTRACT

Background: Blood-related malignancies are the most common non-renal neoplasms affecting the kidneys. Renal involvementin patients with hematological malignancies varies according to the type of malignancy. The pathogenesis is either due to directinvolvement of the kidney or related to its treatment and/or effects of chemotherapy.Aim of the Study This study aims to study and analyze the prevalence of kidney involvement in blood-related malignanciesand to observe the clinical and laboratory profile of patients in various hematological malignancies.Materials and Methods: A total of 93 consecutive patients of various hematological malignancies were included such asHodgkin’s disease, non-Hodgkin’s lymphoma, acute and chronic leukemias, and multiple myeloma. The renal involvement wasjudged on analysis of patient’s clinical parameters, urine analysis, biochemical, radiological, and when necessary, histologicalparameters. All the patients were investigated and treated on an established protocol described in literature. Patients wereadvised to give informed written consent followed by a detailed history taking and relevant physical examination. Patients wereasked about special emphasis on urinary symptoms and usage of nephrotoxic drugs.Observations and Results: A total of 93 consecutive patients of various hematological malignancies presenting to oncologyand medicine departments were included. There were 62 (66.66%) were male and 31 (33.33%) were female with a maleto-female ratio of 21. The youngest patient was aged 11 years and the eldest one was 81 years with a mean age of 43.13 ±16.2 years. Among 93 patients, 46/85 (49.46%) were diagnosed as leukemias, 27/93 (29.03%) patients had lymphomas, and20/93 (21.50%) patients were diagnosed as multiple myelomas. Acute leukemias were seen in 27/46 (58.69%) of the patientsand chronic leukemias in 19/46 (41.30%) of the patients. Forty-six patients with leukemias acute lymphatic leukemia were 7 inmales (25.92%) and 3 (11.11%) in females making it a total of 10/27 (37.03%), acute myeloid leukemia was 6 (22.22%) inmales and 3 (11.11%) in females with a total of 9/27 (33.33%). Acute basophilic leukemia was observed in 5 (18.51%) malepatients and 3 (11.11%) female patients; total 8/27 (29.62%). Chronic myeloid leukemia was seen in 5/19 (26.31%) male and2/19 (10.52%) female patients; 7/19 (36.84%).Conclusions: All patients with hematological malignancies should be periodically evaluated for renal dysfunction and necessarypreventive measures should be undertaken in such patients, especially when initiated on chemotherapy.