Low erythropoietin to albumin ratio in the serum predicts less reversibility of renal impairment with poorer prognosis in multiple myeloma

Abstract Purpose Renal impairment (RI) is a common complication of Multiple myeloma (MM). It is worth noting that the irreversible and sustained decline in renal function in these patients not only seriously affects the optimal treatment options, but also leads to poor prognosis. Currently, there is a lack of a reliable laboratory index to predict whether renal function can be reversed. In this study, we investigated whether the serum erythropoietin (EPO) to albumin ratio can be used as an independent predictor of changes in renal injury after treatment in patients with MM. Methods 52 MM-related RI patients were retrospectively divided into reversible and non- reversible groups according to whether they developed major renal response. Logistic regression analyses were used to explore potential predictors of reversibility of MM-related RI. ROC curves analyses were performed for EPO/albumin and other predictors to determine the best marker to predict reversibility of MM-related RI. The prognostic value of EPO/albumin was investigated by Kaplan-Meier analyses. Results We unexpectedly found serum albumin was higher in the non-reversible group than in the reversible group. Of note, the serum levels of albumin were negatively correlated with EPO in these patients. Importantly, EPO/albumin was an independent predictor of the reversal of MM-related RI. Also, EPO/albumin provided the highest predictive efficiency. When the higher and lower EPO/albumin groups were further defined, the former group exhibited a prolonged OS. Conclusions Serum EPO/albumin is useful for predicting reversibility of MM-related RI. Low EPO/albumin could predict less reversibility of RI with poorer prognosis in MM.