Continuous ambulatory peritoneal dialysis in end-stage renal disease due to multiple myeloma

Abstract

Objective: To evaluate (1) the disease course, (2) the response to recombinant human erythropoietin (rHuEPO), and (3) the morbidity and mortality of patients with end-stage renal disease (ESRD) due to multiple myeloma (MM) who were treated with continuous ambulatory peritoneal dialysis (CARD). Design: Retrospective study. Setting: Tertiary teaching hospital - The Toronto Hospital, Toronto, Ontario, Canada. Patients: Seven patients with ESRD due to MM who were treated with CAPD. Results: Mean age of the patients was 77.2 years (median 80 years, range 65 - 88 years). Two were in stage IB, 1 was in stage IIB, and the remaining 4 were in stage IIIB, according to Durie and Salmon's staging. Three patients received rHuEPO; 2 of these also were receiving chemotherapy for myeloma. The mean rHuEPO requirement was 277 U/kg/wk, which was more than other ESRD patients' requirements. Mean duration of CARD was 20.6 months (6-58 months). The peritonitis rate was one episode in 14.4 months. The frequency of hospitalization was once in 5.6 months, and the mean number of days spent in hospital was 20 days per year. Quality of life did not get worse and, if anything, improved marginally while they were on CARD. Three patients died after a mean survival of 32.7 months, and the remaining 4 patients are still alive. Conclusions: Myeloma patients with ESRD do fairly well on CARD without deterioration in their quality of life and with an acceptable peritonitis rate.