[Kidney involvement in hematologic malignancies. Diagnostic approach].
Kidney involvement is frequent in hematologic malignancies. It is associated with adverse outcome and treatment difficulties. It can affect every area of the renal parenchyma (tubules, interstitium, glomerulus, vessels). Various mechanisms could be implicated: deposits of immunoglobulin fractions or crystals, renal infiltration by malignant cells, urinary tract obstruction, paraneoplastic or storage glomerulopathies… Diagnostic strategy relies on the clinical presentation: acute renal failure, chronic kidney disease, glomerular proteinuria with or without nephrotic syndrome, tubular proteinuria, hydroelectrolytic disorders. In this review, we detail the diagnostic tests that are needed for the detection and the follow-up of renal involvement in hematologic malignancies, and clarify the indications of renal biopsy. We propose diagnostic strategies of renal involvement in myeloma, Waldenström's disease, high grade lymphomas and acute leukemias, low grade lymphomas and chronic leukemias. The adverse effects of treatments (chemotherapy, radiotherapy, stem cell graft …) are not addressed in this review.
Jourde-Chiche
N
N
Centre de néphrologie et de transplantation rénale, hôpital de la Conception, 13385 Marseille cedex 05, France.
Dussol
B
B
Daniel
L
L
D003663:Decision Trees; D019337:Hematologic Neoplasms / Q000150:complications*; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis / Q000209:etiology*; D007938:Leukemia / Q000150:complications; D008223:Lymphoma / Q000150:complications; D009101:Multiple Myeloma / Q000150:complications