RENAL-INSUFFICIENCY IN MULTIPLE-MYELOMA - BASIC MECHANISMS IN ITS DEVELOPMENT AND METHODS FOR TREATMENT

Baseline renal function and the renal reserve capacity were examined i n 60 patients with multiple myeloma (MM). The factors lending to the d evelopment of chronic renal insufficiency (CRI) were explored through a series of conventional studies which included renal ultrasonography. In these patients, the main cause of CRI was hyper(para)proteinemia a nd paraproteinuria. Ultrasonography was important in determining kidne y size, in evaluating the size of the renal parenchyma and calyces, an d in detecting abnormalities in the urodynamics of the upper urinary t ract. Plasmapheresis was shown to be an effective method for the treat ment of established CRI. In addition, plasmapheresis was employed as t he prophylactic therapy when abnormalities were seen on renal ultrason ography el en in the absence of overt functional impairment. Plasmaphe resis may be an efficient measure to protect against tubular injury an d to improve the glomerular filtration rate.