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Managing Myeloma Kidney

Morie A. Gertz, MD
[+] Article, Author, and Disclosure Information

From Mayo Clinic, Rochester, MN 55905.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Morie A. Gertz, MD, Division of Hematology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.

Ann Intern Med. 2005;143(11):835-837. doi:10.7326/0003-4819-143-11-200512060-00013
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It is estimated that, in 2005, multiple myeloma will be diagnosed in 15 980 persons and 11 300 persons will die of it, constituting 2% of all deaths from cancer (1). Although myeloma bone disease and anemia are the primary manifestations of the disorder, only 52% of patients have normal renal function at diagnosis. At presentation, the serum creatinine level is between 114 µmol/L (1.3 mg/dL) and 175 µmol/L (2.0 mg/dL) in 29% of patients and 176 µmol/L or more (≥2.0 mg/dL) in 19% of patients. Therefore, nearly 8000 patients per year will present their physicians with the challenging problem of managing the renal impairment associated with myeloma (2). In many instances, the renal insufficiency associated with multiple myeloma is related to several reversible problems due to volume depletion; hypercalcemia; and exposure to contrast material, nonsteroidal anti-inflammatory drugs, and angiotensin-converting enzyme inhibitors (34). However, the most common finding is cast nephropathy (56).

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Current treatments for renal failure due to multiple myeloma. Expert Opin Pharmacother Published online Sep 20, 2016;
Renal Toxicities of Novel Agents Used for Treatment of Multiple Myeloma. Clin J Am Soc Nephrol Published online Sep 21, 2016;
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