#2776 Monoclonal gammopathies and amyloidosis unit (UGAM-A): importance of the nephrologist in the multidisciplinary approach

Abstract

Abstract Background and Aims The Monoclonal Gammopathies and Amyloidosis Unit (UGAM-A) is a multidisciplinary hospital subcommittee that discusses complex cases in relation to the diagnosis and treatment of patients with blood dyscrasia and amyloidosis. Method Retrospective observational study of the cohort of patients presented at UGAM-A The data were extracted from the minutes of the UGAM-A for the period Jan/18-Dec/22. Results 81 patients were assessed with a median age of 69 years, 52 men (64.2%). HT 58 (71.6%), DM 22 (27.2%), cardiovascular disease 14 (17.3%), Neoplasm 12 (14.8%). 56 patients (69.1%) had renal damage at the time of assessment, 54 with CKD criteria, with a mean creatinine of 1.7 ± 1.0 mg/dl and proteinuria of 1.3 ± 1.7 g/mg. Cardiac involvement was found in 19 patients. There were 37 (45.7%) diagnostic changes after assessment by the UGAM. A total of 22 (27.2%) therapeutic modifications, initiation or change were made. 17 (77.3%) occurred in patients with renal involvement. There were 10 (12.3%) treatment changes, with 22.7% of them improving renal function vs. 7% in the group with no change in treatment (p = 0.04). 8 (9.9%) patients required SDB, with a median time to onset of 452d. A total of 25 (30.9%) patients died, with a median time of 370d, with 12 being the most common cardiac cause, followed by infectious 8. Conclusion Nephrologists should be involved in the complex clinical cases that accompany hematologic diagnoses. In our study, almost 80% of patients had renal involvement concomitant with haematological pathology. The role of the nephrologist is fundamental in clarifying mechanisms of kidney damage and enhancing the initiation of treatment even when they do not meet criteria from the haematological point of view, so that more than 77% of the therapeutic actions took place in patients with renal involvement.