title: Acute renal failure caused by renal infiltration by hematolymphoid malignancy.
abstract: Renal involvement by a malignant infiltrative process is often suspected in patients with bilaterally enlarged kidneys and concurrent malignancies. Acute renal failure (ARF) can rarely occur secondary to such an infiltrative process. We present 2 cases in which ARF is attributable to malignant hematolymphoid infiltration. The first case involves diffuse, bilateral involvement of the kidneys by non-Hodgkin's lymphoma. The patient's renal function improved dramatically after the initiation of chemotherapy, clearly linking the development of ARF to the malignant process. In the second case, infiltration of the kidneys by plasma cell leukemia resulted in dialysis dependence. To our knowledge, this represents the first reported case of ARF attributable to documented renal infiltration by plasma cell leukemia. A review of the potential causes of renal failure in hematolymphoid malignancy, focusing on the direct impact of the infiltrative process and on the spectrum of renal disease in plasma cell dyscrasia, is presented.
authors.affiliation: Department of Internal Medicine, University of Virginia Health System, Charlottesville, VA 22908, USA.
authors.forename: Steven E
authors.initials: SE
authors.lastname: Lommatzsch
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Bellizzi
authors.forename: Helen P
authors.initials: HP
authors.lastname: Cathro
authors.forename: Mitchell H
authors.initials: MH
authors.lastname: Rosner
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology*; D000493:Allopurinol / Q000627:therapeutic use; D000963:Antimetabolites / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology*; D007952:Leukemia, Plasma Cell / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D017254:Leukemic Infiltration; D008228:Lymphoma, Non-Hodgkin / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D008875:Middle Aged; D011859:Radiography; D013792:Thalidomide / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000963:Antimetabolites; D013792:Thalidomide; D000493:Allopurinol; D003907:Dexamethasone