Recently Diagnosed or Relapsed? Stop Looking For a Miracle Cure, and Use Evidence-Based Therapies To Enhance Your Treatment and Prolong Your Remission
Multiple Myeloma an incurable disease, but I have spent the last 25 years in remission using a blend of conventional oncology and evidence-based nutrition, supplementation, and lifestyle therapies from peer-reviewed studies that your oncologist probably hasn't told you about.
Click the orange button to the right to learn more about what you can start doing today.
“In this review, we recognized that there are multiple ways novel anti- multiple myeloma therapies can affect renal function, cause kidney damage.”
Kidney damage is tricky for the multiple myeloma (MM) patient and survivor because MM itself can damage your kidneys. Kidney damage can be a symptom of MM. Further, as the article linked below explains, MM chemotherapy itself causes kidney damage as well.
In all, according to the second article excerpted below, approximately 13% of MM patients die of renal damage aka kidney failure.
The scariest problem facing newly diagnosed MM patients is quoted in the top article in the very first sentence “effects of these therapies can lead to unanticipated effects on the kidney.” In other words, some of these “novel” MM therapies are not old enough, have not been tested enough for oncology to thoroughly understand the degree of kidney damage caused by novel chemotherapy regimens.
Lastly, and this is my own perspective on MM chemotherapy drugs, the negative kidney effects cannot be fully know and understood, until years after chemo administration. Like all long-term and late stage side effects, a MM patient can’t know the full extent of his or her kidney damage until they’ve lived beyond their MM diagnosis for years, even decades, beyond their original MM diagnosis.
“In some cases, off target effects of these therapies can lead to unanticipated effects on the kidney that can range from electrolyte disorders to AKI…
In addition, some novel MM therapies have also been reported to cause kidney injury. These adverse effects are likely to have negative effects on prognosis and may limit the ability of the patient to receive effective treatment. Given myeloma itself can lead to kidney disease, distinguishing between myeloma-related kidney disease and drug toxicity is difficult without a kidney biopsy…
In summary, both lenalidomide and pomalidomide have been associated with kidney dysfunction; however, clinicians must be careful when assessing patients with worsening kidney disease on IMiD as a number of other causes including progression of MM could be responsible for decline in kidney function…
Conclusions
The use of novel targeted therapies has led to significant improvements in survival and overall prognosis with many malignancies. However, there is evolving knowledge of renal adverse events with these agents. Timely recognition of these toxicities can aid in the proper management of patients with myeloma.
In this review, we recognized that there are multiple ways novel antimyeloma therapies can affect renal function. In addition, newer targeted agents are entering clinical trials. With the advent of novel targeted therapies and their use in myeloma, nephrologists and hematologists need to be more vigilant of the renal toxicity potential of these agents…”
“The most common MM progression-related (1A) SOCs (n = 163) were neoplasms (50.9%, n = 83), infections (15.3%, n = 25), renal disorders (12.9%, n = 21), and cardiac disorders (6.7%, n = 11, Fig. 2c). Expressed in the high specific MedDRA term PT, MM (48.5%, n = 79), renal failure (12.9%, n = 21), sepsis (4.3%, n = 7) and pneumonia as well as cardiopulmonal failure (3.7%, n = 6 each) were leading (Fig. 2e)…”
Multiple Myeloma Kidney Injury/Failure
Patients with myeloma who received a bortezomib-based treatment regimen had a decreased risk for acute kidney (renal) injury, according to researchers…
Kidney injury/failure is like bone damage for multiple myeloma (MM) patients. The majority of MM patients suffer from this symptom and side effect of treatment. However, the routine nature of kidney/renal means that this particular health challenge requires MM patients to remain vigilant. Make a point of discussing your kidney health with your oncologist. If a MMer’s kidney damage progresses far enough he/she is in real trouble. The same can be said for MMer’s bone health.
While both excerpts below discuss kidney health in general terms, the point of this post is to focus on AKI for MMers.
Secondly, as ironic as it sounds, while systemic therapy (chemo) can damage the kidneys, according to the study, “Patients with myeloma who received a bortezomib-based treatment (velcade) regimen had a decreased risk for AKI, according to researchers.” Another topic of conversation for you and your oncologist.
I thought the last link below discusses kidney therapies such as diet, supplementation and lifestyle. I would discuss any supplement that you are considering taking with your oncologist.
“Acute kidney injury (AKI) is a clinical syndrome that complicates the course and worsens the outcome in a significant number of hospitalised patients. Recent advances in clinical and basic research will help with a more accurate definition of this syndrome and in the elucidation of its pathogenesis..”
Acute kidney injury appeared to be a common and considerable burden among patients receiving systemic treatment for cancer, according to a population-based study published in Journal of the National Cancer Institute.
“Nearly 1 in 10 patients initiating systemic cancer therapy will experience a hospitalization or receive acute dialysis for acute kidney injury…” “This magnitude of acute kidney injury risk may be underappreciated by both clinicians and patients commencing systemic cancer treatment, given the paucity of existing data.”
Median follow-up was 1.85 years (interquartile range, 0.77-3.83). A total of 10,880 patients in the cohort experienced acute kidney injury over 403,530 patient-years of follow-up.
Researchers observed an AKI rate of 27 per 1,000 person-years and an overall cumulative incidence rate of 9.3% Annual incidence of acute kidney injury nearly tripled during the study period, from 18 to 52 events per 1,000 person-years (P for trend = < .001).
Cancers with the highest 5-year cumulative incidence of AKI were myeloma, bladder cancer and leukemia.
Cancers with the highest HRs for AKI — after adjustment for possible cofounders and relative to breast cancer, which was the referent because it was the most common cancer among the cohort — included multiple myeloma (adjusted HR [aHR] = 4.3; 95% CI, 3.83-4.82), bladder cancer (aHR = 3.69; 95% CI, 3.28-4.16) and cervical cancer (aHR = 3.47, 95% CI, 2.9-4.14).
Patients with myeloma who received a bortezomib-based treatment regimen had a decreased risk for AKI, according to researchers…
Patients aged 66 years or older appeared at higher risk for AKI if they took a prescribed diuretic or angiotensin-converting enzyme inhibitor/angiotensin receptor blocker . Researchers said holding or discontinuing the medications at the time of systemic therapy initiation could decrease the risk for injury…
Limitations of this study included a lack of serum creatinine data and a lack of data surrounding acute kidney injury among patients who were not hospitalized, which could have led to an underestimation of the overall incidence of injury.
“Considerable advances in the treatment of many cancer types have been made in the last decade, including in multiple myeloma and kidney cancers,” Kitchlu and colleagues wrote. “As such, a reassessment of [acute kidney injury] incidence across various cancer types in the current era of cancer treatment is warranted.” – by John DeRosier
Disclosures: This study was funded by the Institute for Clinical Evaluative Sciences. All study authors report no relevant financial disclosures.
“High blood pressure, elevated blood sugar¸ NSAIDs (such as ibuprofen), certain medications, and high-protein diets are the most common threats to kidney health. The potentially lethal insults they inflict include oxidative stress, production of advanced glycation and lipoxidation end products (AGEs and ALEs), inflammation, and an excessive filtration burden that taxes renal function over time.
Nutrients such as pyridoxal-5-phosphate (P5P) fight AGEs and ALEs. CoQ10, silymarin, resveratrol, and lipoic acid are also clinically supported, potent interventions. Omega-3 fatty acids help quell inflammation, contributing to enhanced kidney health. A host of additional nutrients complement these actions, including folic acid (folate) and vitamins C and E.”
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4 comments
Karen Saltz says
a couple of years ago
Thank you so much for this, David.
I will be sure to mention Velcade to my doctor as an option over Rev. Will Dex be ok with my kidneys, and what dosage to you recommend?
I only have about 42 % renal function, so preserving it , is of paramount importance to me. I will ensure my doctor knows that.
Will stop ARB ( Olmetec ) prior to starting treatment. I have been using it off- label , high dose for sarcoidosis for almost two decades.
Your oncologist will have to work with you to determine dose, frequency, other meds such as ARB. As for dex and your kidney function, according to research, I think it is okay but ask your oncologist.
I have stage 3CKD from sarcoidosis. Now, diagnosed with SMM after 9 years of Mgus. Might be MM and waiting to hear if treatment should be started. BMB. 40 %, FLC 30 and M protein 0.5. Anemia for many years, probably related to CKD
If I have to start treatment, I don’t want revlmid, so what alter is safer?
I am sorry to learn of your CKC, sarcoidosis, SMM diagnosis. In my experience while you may have early stage MM in your bone marrow, your kidney health is your main priority. I don’t mean to sound cynical but my view of MM oncology is that they focus on MM and not your kidney health. A remarkable number of conventional MM therapies cause kidney damage.
The linked article below cites low-dose Velcade aka bortezomib as promising kidney function in MM patients. Also, I will email you the MM CC kidney guide. The point of the guide is to take a patients view of kidney health.
