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[The kidney in dysproteinemia]
D Spanti1, C Marcantoni, D Di Landro
1U.O. di Nefrologia e Dialisi, Azienda Ospedaliera Cannizzaro, Catania.
Summary
Dysproteinemias cause kidney damage through paraprotein deposits. Prompt treatment of multiple myeloma (MM)-related kidney failure improves outcomes, but recovery is limited in advanced cases like monoclonal immunoglobulin deposition disease (MIDD) or amyloidosis.
Area of Science:
- Nephrology
- Hematology
- Immunology
Context:
- Dysproteinemias, particularly multiple myeloma (MM), are linked to various kidney diseases.
- Paraprotein deposition in the kidney is a key pathogenic mechanism.
- Myeloma kidney (cast nephropathy), amyloidosis, and monoclonal immunoglobulin deposition disease (MIDD) are common renal complications.
Purpose:
- To summarize the spectrum of renal diseases associated with dysproteinemias.
- To outline the pathogenesis of paraprotein-related kidney injury.
- To review current management strategies and prognoses for renal failure in MM.
Summary:
- Renal failure affects about 50% of MM patients at diagnosis, primarily due to myeloma kidney.
- Prompt rehydration and hypercalcemia treatment can improve renal function in many cases.
- Plasma exchange, corticosteroids, dialysis, and stem cell transplantation (SCT) are treatment options depending on disease severity and type.
Impact:
- Highlights the significant impact of paraprotein deposition on renal health.
- Emphasizes the importance of early diagnosis and multidisciplinary management for MM-associated kidney disease.
- Provides insights into prognostic factors and therapeutic approaches for renal recovery and patient survival.