P-121: Prevalence of multiple myeloma in Ecuadorian hemodialysis units. A SEN study

Introduction: More than half of MM patients suffer renal impairment, often presenting with acute injury due to cast nephropathy, light chain deposition, or amyloidosis. Though long-term hemodialysis is uncommon in MM patients, it greatly affects their quality of life and survival. The 2022 Ecuadorian Ministry of Public Health's "Information Bulletin: Patients in Renal Replacement Therapy (RRT)" lacks data on MM patients in hemodialysis units. Our survey addresses this by reporting the prevalence of MM patients on hemodialysis in Ecuador for the first time.

Methods: This observational, cross-sectional study reports the prevalence of patients diagnosed with MM and end-stage kidney disease in hemodialysis in Ecuador. A survey was developed which was distributed to Ecuadorian nephrologists, and their respective institutions, through the support of the Sociedad Ecuatoriana de Nefrología (SEN).

Data acquisition. The collected information included the total number of patients in hemodialysis units, the number diagnosed with MM, and the type and location of each unit.

Statistics. Specific prevalence was calculated using the following equation:
Prevalence = (Number of Patients with MM treated in the hemodialysis unit / Total number of patients treated in the hemodialysis unit by any cause [N]) x1000
Additionally, we included 95% confidence intervals (95%CI) for prevalence.

Sample. The sample to estimate the minimum number of patients required for this analysis (2744) was calculated based on the equation n=Nz2pq/(d2(N-1) + z2pq) where N was 21780 (Total Ecuadorian population in hemodialysis), using an acceptable error of d = 1%, z of 2.58, and an expected prevalence (p) of 5% based on a previous report.

Results: In this study, conducted across ten Ecuadorian cities, 22 nephrologists from 21 institutions (Public 30%, military 10%, and private 60%) contributed data on a collective total of 2979 patients undergoing hemodialysis. Among these patients, 43 were diagnosed with myeloma. This corresponds to a relative frequency of 1.4%. and a prevalence rate of 14.4 cases per 1000 hemodialysis patients (95%CI 10.1 to 18.7). The prevalence of myeloma varied across cities. Sucúa had the highest rate at 4.44%, followed by Ambato at 3.81%. Guayaquil and Portoviejo had rates of 1.28% and 3.08%, respectively. Quito reported 0.76%, Manta 0.46%, and Ventanas, Ibarra, and Daule had rates around 1.11% to 1.31%. Riobamba recorded no cases.



Conclusions: Our study provides the first prevalence data on MM patients undergoing hemodialysis in Ecuador, revealing significant regional variations. Sucua exhibited the highest prevalence, while Riobamba recorded no cases. This underscores the need for tailored healthcare strategies to address MM-associated renal complications across diverse regions. Future goals include expanding the survey, analyzing the clinical characteristics of this population, and extending this initiative to Latin American Hemodialysis Units.