A Case Report Of Renal Involvement In Multiple Myeloma And Review Of The Literature

Objective: Through the analysis of the case of renal involvement in multiple myeloma,to explore the current epidemiology,pathogenesis,clinical features,pathological manifestations,diagnosis and treatment programs of renal involvement in multiple myeloma,in order to improve the importance of renal involvement in multiple myeloma.Method: Select the patient's clinical data of renal involvement in multiple myeloma,who was treated in nephrology department of the Third Hospital of Hebei Medical University,Combining relevant domestic and foreign literature reports,discuss the epidemiological status,pathogenesis,clinical manifestations,pathological features,diagnosis and treatment measures of renal involvement in multiple myeloma.Results: The patient was a 36-year-old man with nausea,vomiting,and oliguria for 25 days and increasing serum creatinine for 20 days into our hospital.The bone marrow biopsy examination was consistent with the multiple myeloma bone marrow image.Renal biopsy pathological results:confirmed the pathological manifestation of multiple myeloma cast nephropathy.Clinical diagnosis:Multiple myeloma,Renal involvement in multiple myeloma,cast nephropathy,Acute renal failure,Renal hypertension.Treatment programs:regular hemodialysis and TCD(thalidomide75mg continuous oral,cyclophosphamide 1g d1,0.8g d8,Dexamethasone15 mg d1-4,9-12)chemotherapy,the disease condition is almost alleviated.Conclution: Multiple myeloma(MM)is a incurable Malignant plasma cell disease.The disease occurs mostly in middle-aged and elderly men.The pathogenesis is not yet clear.Kidney is a common target organ of MM.In recent years,the incidence rate has been increasing year by year.Acute renal insufficiency or Proteinuria is often as the first manifestation and can bemisdiagnosed or missed.Correct diagnosis,early and reasonable treatment,reversing renal impariment can effectively improve the prognosis.Therefore,how to treat renal involvement in multiple myeloma has become a hot spot in clinical research.Current main treatments include: antimyeloma therapy,renal replacement therapy and many more.Recent studies have shown that high cut-off(HCO)haemodialysis can clear different types of free light chains,reduce rapidly tumor burden,and improve or restore renal function.