Reversible renal insufficiency in multiple myeloma.
Forty-five patients met the criteria for the diagnosis of multiple myeloma in a retrospective chart review from 1975 to 1980. Renal insufficiency with peak serum creatinine concentration greater than 1.5 mg/dL involved 69% of all patients. Renal insufficiency was reversible in 55% of the cases. Treatment of hypercalcemia and/or chemotherapy for multiple myeloma was associated with reversibility in 88% of cases. Once renal insufficiency occurred in patients with multiple myeloma, those with reversible renal failure had a duration of survival fourfold longer (11.4 v 2.8 months) than those with irreversible renal insufficiency. In conclusion, reversible renal insufficiency from hypercalcemia or the myeloma process itself develops in a majority of patients with multiple myeloma. If therapy reverses the renal dysfunction, a greater life expectancy occurs. Patients with multiple myeloma and renal insufficiency should, therefore, be examined for reversible causes of renal dysfunction, since if found and treated, a substantial improvement in prognosis is achieved.
D000328:Adult; D000368:Aged; D001536:Bence Jones Protein / Q000652:urine; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000150:complications; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000503:physiopathology*; D011379:Prognosis; D012189:Retrospective Studies
D001536:Bence Jones Protein; D003404:Creatinine