[Relation between certain parameters of renal function and prognosis in multiple myeloma]

Renal involvement is one of the most common manifestations of MM, with different pathogenetic mechanisms, like overproduction of monoclonal light chains and hypercalcemia, those are commonest precipitating factors for renal failure which occurs in nearly 25% of myeloma patients. Some renal pathology is noted in over half.

We studied retrospectively 16 patients with MM treated at Nephrology and Haemathology Clinic in Sarajevo, in the period from 1996-1999 y (10 females and 6 males). All fulfilled criteria for MM diagnosis: 1. Bone marrow involvement by greater than 20% plasma cells 2. Monoclonal paraprotein in the serum and/or urine 3. Lytic bone lesions.

Appearance of high creatinine plasma level, red and white blood cells in urine, and proteinuria are the signs of renal function reduction. Renal failure was noted in 10/16, erythbruria 6/16, pyuria, 7/16 hyperuricemia in 8/16 and 3/16 (19%) were died during hemodialysis programme, and Bence-Jones protein was noted in urine with 7/16 (43%). Severe renal failure with 5/16 was noted and beside high plasma creatinine we found high plasma calcium and Bence Jones in urine.

High plasma levels of creatinine and calcium and Bence-Jones in urine, are poor prognostic signs of MM.