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Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
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Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
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Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
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Acute Kidney Failure: When Multiple Myeloma Doesn´t Give Additional Clues.

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  • 1Internal Medicine, Hospital Senhora Da Oliveira, Guimarães, PRT.

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Acute kidney failure (AKF) rarely presents as the initial symptom of multiple myeloma (MM). This case highlights AKF as the sole presenting sign in a young woman, emphasizing the importance of considering MM in unexplained AKF.

Keywords:
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Area of Science:

  • Nephrology
  • Oncology
  • Hematology

Background:

  • Multiple myeloma (MM) typically presents with hypercalcemia, renal failure, anemia, and bone lesions.
  • Acute kidney failure (AKF) is an uncommon initial presentation of MM.

Observation:

  • A 49-year-old female presented with AKF, abdominal pain, and vomiting.
  • Extensive workup, including negative infectious and autoimmune markers, normal imaging, and peripheral blood smear, ruled out other causes.
  • Elevated immunoglobulin A (IgA), a monoclonal spike on serum protein electrophoresis, and elevated Kappa light chains in urine were noted.

Findings:

  • Kidney biopsy confirmed myeloma kidney, indicating MM as the cause of AKF.
  • The patient's renal function improved with chemotherapy, with creatinine levels stabilizing post-treatment.

Implications:

  • This case underscores the importance of considering MM in the differential diagnosis of AKF, especially in the absence of typical MM symptoms.
  • Kidney biopsy remains a crucial diagnostic tool for identifying myeloma kidney and guiding treatment in such cases.
  • Early diagnosis and treatment of MM presenting as AKF can lead to improved patient outcomes.