ABSTRACT
The spectrum of renal lesions that was seen in patients with myeloma include myeloma kidney, or cast nephropathy; light chain (AL) amyloidosis; monoclonal Ig deposition disease(MIDD); and less frequently, cryoglobulinemic glomerulonephritis and proliferative glomerulonephritis.ln native renal biopsy studies of patients with myeloma and renal disease, 40 % to 63 % had east nephropathy, 19 % to 26 % had light-chain deposition disease, 7 % to 30 % had amyioidosis, and 1% had eryoglobulinemie renal disease. The renal pathology of cast nephropathy, MIDD, and amyloidosis was diverse.Extrarenal manifestations of MIDD, as with amyloidosis, were frequent, the incidence of renal insufficiency and ESRD was high.The morbidity and mortality were a significant increase.Patient and renal survival were significantly worse in patients with coexisting nephropathy.Therapy of renal lesions with myeloma was similar to that for multiple myeloma and consisted of chemotherapy alone,and treated renal insufficiency with hemodialysis and peritoneal dialysis, and used of high-dosage chemotherapy followed by ASCT to reduced the level of light-chain production.
