ASN 2016: Onco-Nephrology
Prof Richard Glassock wrote:
I went to a session on Onco-Nephrology at the ASN meeting yesterday.
Two randomized controlled trials of high-cut off (HCO) membrane intermittent hemodialysis compared to standard membrane hemodialysis for established AKI secondary to biopsy-proven Myeloma Cast Nephropathy (MCN) were presented (the French MYRE and the New Zealand EuLITETrials).
The primary endpoints were similar (short-term freedom from need for dialysis), but the entry criteria and the basic chemotherapy for Multiple Myeloma administered in conjunction with dialysis were different in the two trials.
Both studies were well powered (n= about 100 cases) but only the MYRE trial had a positive result.
The EuLITE trial failed to show any benefit for HCO dialysis for MCN. Patient survival was not affected in either trial. The differences in the outcomes may well have been due to the trial design characteristics and/or the type of Myeloma chemotherapy utilized. It seems likely that HCO will remain as a controversial therapy for MCN.