{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T15:48:43Z","timestamp":1764604123535,"version":"build-2065373602"},"reference-count":43,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T00:00:00Z","timestamp":1750809600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Multiple myeloma (MM) is frequently associated with cytogenetic abnormalities, with high-risk cytogenetics linked to poorer survival. Acute kidney injury (AKI) is common in MM, but its relationship with high-risk cytogenetics remains underexplored. This study aimed to assess the association between high-risk cytogenetics and AKI in newly diagnosed MM patients and to evaluate their impact on overall survival, relapse-free survival, and progression to chronic kidney disease (CKD) in the first two years after diagnosis. We conducted a single-center retrospective cohort study including patients newly diagnosed with MM between 2018 and 2022. We enrolled 122 patients. AKI was observed in 36.9% of patients, rising to 62.3% among those with high-risk cytogenetics. High-risk cytogenetics (OR: 3.32; 95% CI: 1.17\u20136.40; p = 0.024), CKD (OR: 9.14; 95% CI: 2.92\u201318.65; p &lt; 0.001), kappa free light chains, hypercalcemia, difference in free light chain (dFLC), and bone marrow plasmocyte percentage were independently associated with AKI. Both AKI (HR: 2.71; 95% CI: 1.18\u20136.23; p = 0.019) and high-risk cytogenetics (HR: 3.33; 95% CI: 1.13\u20139.76; p = 0.029) were independently associated with lower overall survival. Among survivors without prior CKD, progression to CKD was higher in those with AKI (30.7% vs. 9.3%; p = 0.041). High-risk cytogenetics were significantly associated with AKI in MM patients. Both factors independently predict worse survival and increased risk of CKD progression.<\/jats:p>","DOI":"10.3390\/ijms26136108","type":"journal-article","created":{"date-parts":[[2025,6,26]],"date-time":"2025-06-26T06:55:13Z","timestamp":1750920913000},"page":"6108","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Role of High-Risk Cytogenetics in Acute Kidney Injury of Newly Diagnosed Multiple Myeloma: A Cohort Study"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3073-0253","authenticated-orcid":false,"given":"Carolina","family":"Branco","sequence":"first","affiliation":[{"name":"Division of Nephrology and Renal Transplantation, Unidade Local de Sa\u00fade Santa Maria, 1649-035 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel","family":"Silva","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Renal Transplantation, Unidade Local de Sa\u00fade Santa Maria, 1649-035 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natacha","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Renal Transplantation, Unidade Local de Sa\u00fade Santa Maria, 1649-035 Lisbon, Portugal"},{"name":"Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7245-3012","authenticated-orcid":false,"given":"Joana","family":"Vieira","sequence":"additional","affiliation":[{"name":"Division of Hematology, Unidade Local de Sa\u00fade Santa Maria, 1649-035 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo\u00e3o","family":"Forjaz Lacerda","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal"},{"name":"Division of Hematology, Unidade Local de Sa\u00fade Santa Maria, 1649-035 Lisbon, Portugal"},{"name":"Gulbenkian Institute for Molecular Medicine (GIMM), 1649-028 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Ant\u00f3nio","family":"Lopes","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Renal Transplantation, Unidade Local de Sa\u00fade Santa Maria, 1649-035 Lisbon, Portugal"},{"name":"Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisbon, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"57","DOI":"10.5644\/ama2006-124.242","article-title":"Multiple Myeloma Genomics\u2014A Concise Review","volume":"48","author":"Castaneda","year":"2019","journal-title":"Acta Med. Acad."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1038\/s41571-018-0018-y","article-title":"The multiple myelomas\u2014Current concepts in cytogenetic classification and therapy","volume":"15","author":"Kumar","year":"2018","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1038\/nrclinonc.2016.122","article-title":"Genomic Complexity of multiple myeloma and its clinical implications","volume":"14","author":"Manier","year":"2017","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/S1470-2045(14)70442-5","article-title":"International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma","volume":"15","author":"Rajkumar","year":"2014","journal-title":"Lancet Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e365","DOI":"10.1038\/bcj.2015.92","article-title":"Interpretation of cytogenetic results in multiple myeloma for clinical practice","volume":"5","author":"Rajan","year":"2015","journal-title":"Blood Cancer J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2713","DOI":"10.1182\/blood-2015-06-650242","article-title":"Under-standing the role of hyperdiploidy in myeloma prognosis: Which trisomies really matter?","volume":"12","author":"Chretien","year":"2015","journal-title":"Blood"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e600","DOI":"10.1038\/bcj.2017.83","article-title":"Prognostic implications of abnormalities of chromosome 13 and the presence of multiple cytogenetic high-risk abnormalities in newly diagnosed multiple myeloma","volume":"7","author":"Binder","year":"2017","journal-title":"Blood Cancer J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1038\/s41375-018-0196-8","article-title":"A high-risk, Double-Hit, group of newly diagnosed myeloma identified by genomic analysis","volume":"33","author":"Walker","year":"2019","journal-title":"Leukemia"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"762","DOI":"10.1007\/s12185-022-03353-5","article-title":"Multiple myeloma with high-risk cytogenetics and its treatment approach","volume":"115","author":"Hanamura","year":"2022","journal-title":"Int. J. Hematol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e433520","DOI":"10.1200\/EDBK_433520","article-title":"Navigating High-Risk and Ultrahigh-Risk Multiple Myeloma: Challenges and Emerging Strategies","volume":"44","author":"Rees","year":"2024","journal-title":"Am. Soc. Clin. Oncol. Educ. Book"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"3406","DOI":"10.1200\/JCO.21.02614","article-title":"Second Revision of the International Staging System (R2-ISS) for Overall Survival in Multiple Myeloma: A European Myeloma Network (EMN) Report Within the HARMONY Project","volume":"40","author":"Cairns","year":"2022","journal-title":"J. Clin. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"104264","DOI":"10.1016\/j.lpm.2024.104264","article-title":"Kidney disease in multiple myeloma","volume":"54","author":"Bridoux","year":"2025","journal-title":"Presse Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2380301","DOI":"10.1080\/07853890.2024.2380301","article-title":"Prognosis of concurrent renal impairment at diagnosis of multiple myeloma: A systematic review","volume":"56","author":"Zhang","year":"2024","journal-title":"Ann. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"722","DOI":"10.1093\/ndt\/gfy079","article-title":"Aetiology and management of acute kidney injury in multiple myeloma","volume":"33","author":"Sprangers","year":"2018","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"317","DOI":"10.34067\/KID.0000000692","article-title":"Kidney Disease and Hematopoietic Stem Cell Transplantation","volume":"1","author":"Renaghan","year":"2025","journal-title":"Kidney360"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1007\/s40620-023-01809-3","article-title":"Acute kidney injury in multiple myeloma patients undergoing autologous hematopoietic stem cell transplant: A cohort study","volume":"37","author":"Rodrigues","year":"2024","journal-title":"J. Nephrol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1385\/MO:18:1:39","article-title":"The implication of compromised renal function at presentation in myeloma: Similar outcome in patients who receive high-dose therapy: A single-center study of 251 previously untreated patients","volume":"18","author":"Sirohi","year":"2001","journal-title":"Med. Oncol."},{"key":"ref_18","first-page":"741","article-title":"Clinical analysis of newly diagnosed multiple myeloma patients with renal dysfunction","volume":"17","author":"Zhu","year":"2015","journal-title":"Zhonghua Yi Xue Za Zhi"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1093\/ndt\/gfz211","article-title":"Incidence, prognostic impact and clinical outcomes of renal impairment in patients with multiple myeloma: A population-based registry","volume":"36","author":"Courant","year":"2021","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1111\/j.1600-0609.1994.tb00190.x","article-title":"Renal function in newly diagnosed multiple myeloma\u2014A demographic study of 1353 patients","volume":"53","author":"Knudsen","year":"1994","journal-title":"Eur. J. Haematol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"21","DOI":"10.4065\/78.1.21","article-title":"Review of 1027 Patients with Newly Diagnosed Multiple Myeloma","volume":"78","author":"Kyle","year":"2003","journal-title":"Mayo Clin. Proc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1159\/000442511","article-title":"Current Trends of Renal Impairment in Multiple Myeloma","volume":"1","author":"Yadav","year":"2016","journal-title":"Kidney Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1080\/10428190601126602","article-title":"Renal failure in multiple myeloma: Incidence, correlations, and prognostic significance","volume":"48","author":"Bamias","year":"2007","journal-title":"Leuk. Lymphoma"},{"key":"ref_24","unstructured":"KDIGO Group (2012). KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Int. Suppl., 2, 124\u2013138."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"R204","DOI":"10.1186\/cc2872","article-title":"Acute renal failure\u2014Definition, outcome measures, animal models, fluid therapy and information technology needs: The Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group","volume":"8","author":"Bellomo","year":"2004","journal-title":"Crit. Care"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"R31","DOI":"10.1186\/cc5713","article-title":"Acute Kidney Injury Network: Report of an initiative to improve outcomes in acute kidney injury","volume":"11","author":"Mehta","year":"2007","journal-title":"Crit. Care"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1038\/s41408-020-00348-5","article-title":"Cytogenetic abnormalities in multiple myeloma: Association with disease characteristics and treatment response","volume":"10","author":"Abdallah","year":"2020","journal-title":"Blood Cancer J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1038\/leu.2013.258","article-title":"Relationship between initial clinical presentation and the molecular cytogenetic classification of myeloma","volume":"28","author":"Greenberg","year":"2024","journal-title":"Leukemia"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1681\/ASN.2007080837","article-title":"Acute kidney injury increases risk of ESRD among elderly","volume":"20","author":"Ishani","year":"2009","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1681\/ASN.2005060668","article-title":"Incidence and mortality of acute renal failure in Medicare beneficiaries, 1992 to 2001","volume":"17","author":"Xue","year":"2006","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1053\/j.ajkd.2015.02.338","article-title":"A Meta-analysis of the Association of Estimated GFR, Albuminuria, Diabetes Mellitus, and Hypertension with Acute Kidney Injury","volume":"66","author":"James","year":"2015","journal-title":"Am. J. Kidney Dis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"S41","DOI":"10.1016\/j.nephro.2016.02.005","article-title":"Acute kidney injury and chronic kidney disease: From the laboratory to the clinic","volume":"12","author":"Ferenbach","year":"2016","journal-title":"Nephrol. Ther."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Men\u00e8, P., Moioli, A., Stoppacciaro, A., Lai, S., and Festuccia, F. (2021). Acute Kidney Injury in Monoclonal Gammopathies. J. Clin. Med., 28.","DOI":"10.3390\/jcm10173871"},{"key":"ref_34","first-page":"173","article-title":"Light Chain Cast Nephropathy in Multiple Myeloma: Prevalence, Impact and Management Challenges","volume":"13","author":"Stoppacciaro","year":"2022","journal-title":"Int. J. Nephrol. Renovasc Dis."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1038\/s41408-023-00806-w","article-title":"Multiple myeloma with acute light chain cast nephropathy","volume":"29","author":"Leung","year":"2023","journal-title":"Blood Cancer J."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1002\/ajh.26590","article-title":"Multiple myeloma: 2022 update on diagnosis, risk stratification, and management","volume":"97","author":"Rajkumar","year":"2022","journal-title":"Am. J. Hematol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"148","DOI":"10.3324\/haematol.2013.087585","article-title":"Bortezomib before and after autologous stem cell transplantation overcomes the negative prognostic impact of renal impairment in newly diagnosed multiple myeloma: A subgroup analysis from the HOVON-65\/GMMG-HD4 trial","volume":"99","author":"Scheid","year":"2014","journal-title":"Haematologica"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies","volume":"370","author":"Altman","year":"2007","journal-title":"Lancet"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1272","DOI":"10.3324\/haematol.2011.056176","article-title":"Report from the European Myeloma Network on interphase FISH in multiple myeloma and related disorders","volume":"97","author":"Ross","year":"2012","journal-title":"Haematologica"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"604","DOI":"10.7326\/0003-4819-150-9-200905050-00006","article-title":"A New Equation to Estimate Glomerular Filtration Rate","volume":"150","author":"Levey","year":"2009","journal-title":"Ann. Intern. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2089","DOI":"10.1111\/j.1523-1755.2005.00365.x","article-title":"Definition and Classification of Chronic Kidney Disease: A Position Statement from Kidney Disease: Improving Global Outcomes (KDIGO)","volume":"67","author":"Levey","year":"2005","journal-title":"Kidney Int."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1080\/01621459.1999.10474144","article-title":"A Proportional Hazards Model for the Subdistribution of a Competing Risk","volume":"94","author":"Fine","year":"1999","journal-title":"J. Am. Stat. Assoc."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1038\/bmt.2012.282","article-title":"Suggestions on the Use of Statistical Methodologies in Studies of the Euro-pean Group for Blood and Marrow Transplantation","volume":"48","author":"Iacobelli","year":"2013","journal-title":"Bone Marrow Transplant."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/13\/6108\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:58:32Z","timestamp":1760032712000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/26\/13\/6108"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,25]]},"references-count":43,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2025,7]]}},"alternative-id":["ijms26136108"],"URL":"https:\/\/doi.org\/10.3390\/ijms26136108","relation":{},"ISSN":["1422-0067"],"issn-type":[{"type":"electronic","value":"1422-0067"}],"subject":[],"published":{"date-parts":[[2025,6,25]]}}}