Renal insufficiency occurs commonly in multiple myeloma, and its presence has been considered the single most important factor in determining prognosis (1). Renal insufficiency has been attributed to any of these factors: hypercalcemia, hyperuricemia, increased plasma viscosity, intravenous urography (particularly after dehydration), pyelonephritis, amyloidosis, plasma cell infiltration of the kidney, or intratubular precipitation of light chains ("myeloma kidney") (1, 2). Patients with myeloma kidney can recover from acute renal failure. Reversal of chronic end-stage renal failure, however, has not been previously reported.
A 61-year-old woman complained of nausea, vomiting, weakness, and fatigue and was hospitalized in her community in August