BACKGROUND: Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy 
and skin changes (POEMS) syndrome is a multisystem disorder arising from 
underlying plasma cell dyscrasia. Renal impairment and related pathological 
changes have been reported, but data on its prevalence, response to therapy and 
impact on survival are still lacking.
METHODS: We retrospectively reviewed 299 patients diagnosed with POEMS syndrome 
in a tertiary-care university hospital from 2000 until 2014. The estimated 
glomerular filtration rate (eGFR) was used to define renal impairment and 
response, according to International Myeloma Working Group criteria. We examined 
the impact of renal impairment and response on patient survival.
RESULTS: Sixty-seven patients (22.4%) had renal impairment (eGFR < 60 
mL/min/1.73 m(2)) at baseline. In a multivariate analysis, ascites was 
independently associated with renal impairment [odds ratio (OR) 12.366, P < 
0.001]. Renal impairment was reversible in 66.0% of patients receiving therapy 
and was associated with a shorter time interval between symptom onset and 
treatment (OR 0.059, P = 0.043) and a vascular endothelial growth factor 
remission (OR 15.958, P = 0.050) in a multivariate analysis. In terms of 
therapy, patients with a renal response more commonly received a novel 
agent-based regimen (P = 0.037), which also led to a shorter response time (P = 
0.001). With a median follow-up of 27.4 months, inferior survival was observed 
in patients with severe renal impairment (eGFR < 30 mL/min/1.73 m(2)), but not 
in those with moderate dysfunction (eGFR 30-59 mL/min/1.73 m(2)), compared with 
patients without renal impairment. A renal response, if achieved, predicted 
improved survival.
CONCLUSIONS: Renal impairment is a common complication of POEMS syndrome, but 
can be reversed with effective therapy in most cases.