Knowledge, Awareness, and Practice Patterns of Nephrologists in the Diagnosis and Management of Multiple Myeloma (MIND-MM Study): A Cross-Sectional, Web-Based, CHERRIES-Compliant Survey with Position Statement from the Indian Myeloma Academic Groupe (IMAGe) and Indian Society of Nephrology (ISN).

BACKGROUND

Multiple myeloma (MM) frequently presents with renal manifestations, positioning nephrologists as key frontline clinicians for early diagnosis. However, the knowledge, awareness, and practice (KAP) patterns of nephrologists regarding MM and related entities, including monoclonal gammopathy of renal significance (MGRS), kidney transplantation, and autologous stem cell transplant (ASCT) in renal failure, remain poorly characterised.

OBJECTIVE

To assess nephrologists' knowledge, awareness, diagnostic approach, management practices, confidence, and educational needs regarding MM and related entities, including monoclonal gammopathy of renal significance (MGRS), kidney transplantation, and autologous stem cell transplantation (ASCT), in the context of renal failure.

METHODS

A cross-sectional, web-based, anonymous e-survey was conducted among practicing nephrologists across India (April 2026). The CHERRIES compliant instrument comprised 52 items across 12 sections covering knowledge, diagnostics, management, practice patterns, confidence, newer therapies, transplant, and MGRS. Content validity was established through expert panel review (CVI methodology). Descriptive statistics were used for analysis.

RESULTS

Of 100 respondents, 97 consented (participation rate 97%); 93 completed demographics and completion rate across all sections ranged from 67% to 77%. Knowledge of myeloma presentations was high (hypercalcemia: 94.2%; bone pain: 88.4%), but recognition of recurrent infections was low (50.0%). Most identified cast nephropathy as the most common renal pathology (74.4%) and the combination of SPEP + sFLC + IFE as the optimal screening (95.4%). MGRS awareness was excellent (100% correct definition; 94% endorsed clone-directed therapy). However, 36% had received no formal training, and awareness of bispecific antibodies (27.4%) and antibody-drug conjugates (15.1%) was notably low. Cost of investigations (68.4%) and referral dealys (46.1%) were the top practice barriers. Nearly all respondents (96.1%) desired structured education.

CONCLUSIONS

Indian nephrologists demonstrate strong foundational knowledge, but have significant gaps in newer therapies awareness and formal training. These findings provide the evidence base for the joint IMAGe-ISN position statement on plasma cell disorders in nephrology.