[The basic mechanisms of the development of kidney failure and the methods for its correction in multiple myeloma]

Area of Science:

• Nephrology
• Hematology
• Medical Imaging

Background:

• Multiple myeloma (MM) is a plasma cell malignancy associated with significant renal complications.
• Chronic renal failure (CRF) is a common and serious complication in MM patients.
• Understanding the mechanisms of renal damage in MM is crucial for effective management.

Observation:

• Sixty MM patients were evaluated for kidney function and urinary tract reserve.
• Renal sonography was employed alongside routine examinations.
• Proteinemia and paraproteinuria were identified as primary contributors to CRF in MM.

Findings:

• Sonography allows assessment of kidney size, parenchyma, and calyceal system status.
• Renal sonography can detect upper urinary tract urodynamic derangements in latent CRF stages.
• Therapeutic plasmapheresis emerged as an effective method for managing CRF in MM.

Implications:

• Early detection of renal impairment using sonography in MM is vital.
• Therapeutic plasmapheresis is recommended for MM patients, even with latent renal failure.
• Plasmapheresis may prevent tubular damage and enhance kidney filtration and reabsorption capacities in MM.