| Objective:The incidence of renal damage by multiple myeloma is considerable high. Whencombining renal damages, the prognosis is poor and the clinical manifestations ofmultiple myeloma nephropathy patients are lack of specificity. Therefore, it oftenresults in misdiagnosis and missed diagnosis. Through retrospective analysis ofmultiple myeloma patients’ clinical manifestations and laboratory tests, to discuss thedistinguishing features of multiple myeloma nephropathy patients’ blood and urinetests, in order to achieve early diagnosis of these diseases.Methods:35patients with multiple myeloma who was diagnosed in Xuanwu Hospital ofCapital Medical University from June2006to October2012were selected as theresearch object. To collect these patients’ gender, age, blood pressure, bone lesions,and anasarcous situation when they were diagnosed. To collect and collate theirroutine blood test, biochemistry, erythrocyte sedimentation rate (ESR), blood, urinaryβ2-microglobulin and24-hour urinary protein before they took chemotherapy.According to values of serum creatinine (176.8umol/L), patients were divided intonormal renal function group of24cases and renal dysfunction group of11cases.Through statistic analyzing laboratory indicators of these two groups of patients, toexplore the characteristics of laboratory tests of the multiple mteloma patients withnephropathy.Results:1. Among35multiple myeloma patients,11cases are renal dysfunction. The incidence of renal damage was31.4%, including8cases of male patients,3cases offemale patients. The male to female ratio is2.67:1.2. According to2011Chinese Diagnosis and Treatment of Multiple Myeloma GuideInternational Staging System (ISS stage) to stage: among them,17cases are Ⅲstagepatients, the rate was48.6%. In renal dysfunction group, a total of9cases are Ⅲstagepatients, the incidence was81.8%; in normal renal function group, a total of8casesare Ⅲ stage patients, the incidence rate was33.3%. The difference between the twogroups was statistically significant (P <0.05).3. Bone X-ray examinations were conducted to all multiple myeloma patients. Inrenal dysfunction group, the number of patients accompanied by two and more thantwo bone damages was8, the incidence was72.7%; in normal renal function group,the number of patients accompanied by two and more than two bone damages was9,the incidence was37.5%. The difference between the two groups was not statisticallysignificant (P>0.05).4. Among the renal dysfunction group with11patients,6received treatment innephrology. Due to reasons such as fatigue, emaciation, or fever, the majority ofpatients were found that their serum creatinine rose in laboratory tests. In view thefounding that foam in urine increased, one patient received treatment in nephrology.Among renal dysfunction group, one patient’s blood pressure>140/90mmHg, whenhe received treatment. One patient’s both lower limbs are mild edema, when hereceived treatment. When rest of the patients received treatment，different from thecommon manifestations of kidney disease, their blood pressures were all stay withinthe normal range, moreover eyelid and lower extremity edema could not be found.5. Statistic analysis showed that hemoglobin, serum calcium, blood uric acid, andblood β2-microglobulin have significant differences between the two groups, P <0.05.By drawing a scatterplot, it found that serum calcium, blood uric acid, and blood β2-microglobulin are linearly related with serum creatinine. Hemoglobin did not havea linear correlation with serum creatinine.6. Multiple linear regression analysis showed that blood β2-microglobulin and urinaryβ2-microglobulin had influences on serum creatinine. Among them, bloodβ2-microglobulin had the most significant influence on serum creatinine.Conclusions:1. Multiple myeloma nephropathy patients have severe anemia and are frequentlyaccompanied with hypercalcemia and hyperuricemia instead of edema orhypertension;2. Blood, urinary β2-microglobulin were indicators for assessment of multiplemyeloma patients with renal dysfunction. |
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