Factors Affecting the Recovery of Renal Function in Geriatric Multiple Myeloma Patients after Hemodialysis.

Multiple myeloma (MM) is a disease of the elderly. Renal failure is a common complication in MM. In this study, we evaluated clinical and laboratory parameters that might contribute to the recovery of renal function in geriatric MM patients. Twenty-five geriatric patients aged >65 years were retrospectively compared with 20 patients aged <65 years with a diagnosis of MM and renal failure between October 2016 and October 2019. Variables that might be associated with the discontinuation of dialysis in these patients were examined in the 6 months of follow-up after the diagnosis. Among the geriatric patients aged >65 years, 100% remained on regular hemodialysis (HD) at the end of the follow-up period in contrast to eight patients (40%) in the younger group, and this was statistically significant P = 0.001. We have noticed that geriatric patients who required maintenance HD had lower mean hemoglobin concentrations (P = 0.02), and higher mean serum calcium (P = 0.03). Other factors were statistically insignificant. Our study showed that age of >65 years, hemoglobin levels, and serum calcium were significantly different between the group who recovered from renal failure and those who required a continuation of HD, but none was an independent prognostic factor for predicting the probability of recovery from severe renal failure and discontinuation of HD in both groups studied.

Effect of Insulin Degludec Versus Insulin Glargine on Glycemic Variability in Patients With Renal Transplantation with Pre-existing Type 2 Diabetes Mellitus; A 1-year, Randomized, Treat-to-Target Pilot Trial.

INTRODUCTION: This study hypothesized that the insulin Degludec may have benefit if used in management of diabetes mellitus after renal transplantation to achieve better control at the critical time of adjustment of immunosuppressive regimens during the first year post transplant. METHODS: Fifty patients with Type 2 diabetes Mellitus after renal transplantation with stable serum creatinine with glycosylated hemoglobin (HbA1C) 7 to 11% were included in the study to receive either Insulin Degludec or Insulin Glargine. Fasting blood glucose, 2 hour post-prandial levels and (HbA1c), were measured at 12, 16, 26, 40, and 52 weeks after renal transplantation also hypoglycemic episodes were documented all through the study. RESULTS: Despite both groups are matched as regards demographic and metabolic data, FPG, and 2h PPG were lower in insulin Degludec group all through the study. HbA1c most pronounced decline, occurred at 52th week of treatment in both groups. The most important clinically relevant finding in our study was that; the overall confirmed hypoglycemia rates and the rate of nocturnal confirmed hypoglycemia was significantly lower with Degludec treated group (P < .001). CONCLUSION: Insulin Degludec provides optimum glycemic control in in the first year post-renal transplant patients with significantly lower rate of hypoglycemia. DOI: 10.52547/ijkd.6131.