[Renal onset of multiple myeloma]

67 patients with multiple myeloma with different duration and stage were studied. In 12 patients (17.91%) the onset of the disease was manifested by renal symptoms which were mistaken for primary renal disease. This group of patients was compared with the patients with usual onset of the disease by clinical, paraclinical and immunologic parameters. 75% of the patients with renal onset were in the III stage of the disease when the correct diagnosis was made. A tendency toward normal proteinuria (80.6 +/- 12.04 g/l), stable azotemia (creatinine 497.83 +/- 313.96 mmol/l), significant and non-selective proteinuria, positive correlation with light-chain secretion (r = +0.77) and lack of therapeutic response in 41.66% of the patients were found. Suggestions about the frequency, characteristics, diagnostic problems, therapeutic responses and the unfavourable prognosis of multiple myeloma with renal onset are put forward.