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[Renal failure]
1Third Department of Internal Medicine, Teikyo University School of Medicine.
Abstract:
Renal failure is a common complication of multiple myeloma, because the kidney is a major target organ for the deposition of paraproteins such as Bence Jones protein (BJP), light chain fragment of monoclonal immunoglobulins, secreted by plasmacytoma. There are three forms of renal involvements related to multiple myeloma. The most common form is cast nephropathy ("myeloma kidney") due to precipitation of BJP combined with Tamm-Horsfall protein in the distal nephron. Other two forms are amyloid nephropathy and light chain deposition disease (LCDD). Renal failure is usually arising from myeloma kidney and is exacerbated by many other factors, for example, concurrently imposed chemical agents. In this manuscript, the mechanism of renal failure mainly due to myeloma kidney and its managements are mainly described.
Insights
Multiple myeloma frequently causes kidney failure through paraprotein deposition, primarily in myeloma kidney. This review details the mechanisms and management of myeloma kidney disease.
Area of Science:
- Nephrology
- Oncology
- Immunology
Context:
- Multiple myeloma, a cancer of plasma cells, commonly affects the kidneys.
- Kidney damage occurs due to paraprotein deposition, particularly Bence Jones protein (BJP).
- Three main forms of renal involvement exist: cast nephropathy (myeloma kidney), amyloid nephropathy, and light chain deposition disease (LCDD).
Purpose:
- To describe the primary mechanism of renal failure in multiple myeloma, focusing on myeloma kidney.
- To outline the management strategies for myeloma kidney disease.
Summary:
- Myeloma kidney, the most common renal complication, results from Bence Jones protein precipitation with Tamm-Horsfall protein in the distal nephron.
- Renal failure is often exacerbated by external factors, including certain chemical agents.
- Understanding these mechanisms is crucial for effective patient management.
Impact:
- Improved understanding of myeloma kidney pathogenesis.
- Guidance for clinical management of renal complications in multiple myeloma patients.
- Potential for improved patient outcomes and quality of life.