Renal disease in multiple myeloma

B. Iványi, Gyula Varga, Sándor Berkessy

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Multiple myeloma is a malignant tumor of B (plasma) cells that is characterized by monoclonal immunoglobulin production. The incidence of myeloma is increasing worldwide, particularly among individuals of advanced age. Renal impairment at diagnosis is present in approximately 20% of patients with myeloma, and uremia is the cause of death in about 15%. Several renal disorders may be present in myeloma. Bence Jones cast nephropathy (BJCN), acute tubular necrosis, and "nonspecific" tubulointerstitial nephritis are related to nephrotoxic light chains in urine. Hypercalcemia potentiates the toxicity of urinary light chains. The tissue deposition of light chains leads to renal AL-amyloidosis or light chain deposition nephropathy (LCDN). In necropsy series, the incidence of BJCN, renal AL-amyloidosis, and LCDN is about 30%, 10%, and 4%, respectively. Clinically, urinary nephrotoxic light chain-associated disorders and LCDN are usually manifested in chronic or acute renal failure. The nephrotic syndrome is commonly due to renal AL-amyloidosis. Most cases of end-stage renal failure are due to BJCN and LCDN. The basic therapy of renal impairment is hydration, forced diuresis, and initiation of chemotherapy. Diphosphonates are effective new tools for the correction of hypercalcemia, and decrease the incidence of pathological fractures. In acute renal failure, plasma exchange in association with forced diuresis, dialysis, and chemotherapy may improve renal function. End-stage renal failure requires maintenance renal replacement therapy. In myeloma patients with advanced age, the limits of medical intervention should be judged individually. Particular attention should be paid to the supportive care of the patients.

Original languageEnglish
Pages (from-to)25-34
Number of pages10
JournalGeriatric Nephrology and Urology
Volume2
Issue number1
DOIs
Publication statusPublished - Jan 1992

Fingerprint

Multiple Myeloma
Kidney
Light
Amyloidosis
Chronic Kidney Failure
Diuresis
Hypercalcemia
Acute Kidney Injury
Incidence
Drug Therapy
Interstitial Nephritis
Spontaneous Fractures
Plasma Exchange
Plasmacytoma
Renal Replacement Therapy
Uremia
Diphosphonates
Nephrotic Syndrome
Immunoglobulins
Dialysis

Keywords

  • Bence Jones cast nephropathy
  • diphosphate
  • light chain deposition nephropathy
  • multiple myeloma
  • renal AL-amyloidosis
  • renal insufficiency

ASJC Scopus subject areas

  • Urology
  • Nephrology
  • Geriatrics and Gerontology

Cite this

Renal disease in multiple myeloma. / Iványi, B.; Varga, Gyula; Berkessy, Sándor.

In: Geriatric Nephrology and Urology, Vol. 2, No. 1, 01.1992, p. 25-34.

Research output: Contribution to journalArticle

Iványi, B. ; Varga, Gyula ; Berkessy, Sándor. / Renal disease in multiple myeloma. In: Geriatric Nephrology and Urology. 1992 ; Vol. 2, No. 1. pp. 25-34.
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