Recovery of severe renal failure in multiple myeloma
Abstract
In 10% of cases Multiple myeloma (MM) begins with severe uremia, thus these patients require renal replacement therapy. We studied 14 patients with newly diagnosed MM. In all these patients the disease debuted with severe stage renal failure. Renal biopsy was performed before chemotherapy with the subsequent light, immunofluorescent and electron microscopy. As a result of the treatment renal function has improved in 4 (28%) patients that allowed us to stop haemodialysis. In other patients after chemotherapy the improvement of renal function has not occurred and haemodialysis has been continued. Study of kidneys biopsies of the patients with MM and severe renal failure in 50% of cases has revealed combined character of renal injury: cast nephropathy and monoclonal light chains deposits, and fibrillar nephropathy. Isolated myeloma nephropathy was diagnosed in 43% of cases. The absence of interstitial fibrosis is the morphological criterion of reversibility of renal failure. Significant interstitial fibrosis in МM patients and severe renal failure develop within two-three months.
About the Authors
I. G. Rekhtina
Гематологический научный центр РАМН
Russian Federation
Russian Federation
E.P. Golitsina. Varshavsky
ГОУ ВПО Московская медицинская академия им. И.М. Сеченова; г. Москва
Russian Federation
Russian Federation
S. V. Gorchakova
ГОУ ВПО Московская медицинская академия им. И.М. Сеченова; г. Москва
Russian Federation
Russian Federation
L. S. Biryukova
Гематологический научный центр РАМН
Russian Federation
Russian Federation
Л. Бирюкова
Гематологический научный центр РАМН
Russian Federation
Russian Federation
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Review
For citations:
Rekhtina I.G., Varshavsky E.G., Gorchakova S.V., Biryukova L.S., Recovery of severe renal failure in multiple myeloma. Nephrology and Dialysis. 2009;11(3):257-262. (In Russ.)
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