Renal function in patients with multiple myeloma

Ralph A Defronzo, C. R. Cooke, J. R. Wright, R. L. Humphrey

Research output: Contribution to journalArticle

105 Citations (Scopus)

Abstract

Renal tubular and glomerular functions were evaluated in 35 consecutive patients with multiple myeloma and were correlated with changes in renal histopathology and myeloma protein patterns. All nine patients without Bence Jones proteinuria had C(Cr)>50 50 ml/min. In contrast 16/26 patients with Bence Jones proteinuria had C(Cr)<50 ml/min and the magnitude of the Bence Jones proteinuria correlated well with the degree of renal insufficiency. Frequent abnormalities in renal tubular acidifying and concentrating ability were observed only in patients with Bence Jones proteinuria and occurred in the absence of significant reductions of glomerular filtration rate. Severely deranged renal histology was seen only in patients with Bence Jones proteinuria and consisted primarily of tubular atrophy and degeneration; glomeruli appeared normal. These data suggest that Bence Jones proteins exert a direct nephrotoxic effect at the tubular level with resultant tubular dysfunction and tubular atrophy. Glomerular filtration rate remains relatively preserved despite the significant abnormalities of tubular function. Although obstructing tubular casts were observed only in patients with severely impaired glomerular filtration rate, many patients with similarly impaired renal function had no evidence of such casts. Instead, tubular atrophy and degeneration correlated best with renal dysfunction.

Original languageEnglish (US)
Pages (from-to)151-166
Number of pages16
JournalMedicine
Volume57
Issue number2
StatePublished - 1978
Externally publishedYes

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Multiple Myeloma
Proteinuria
Kidney
Glomerular Filtration Rate
Atrophy
Bence Jones Protein
Myeloma Proteins
Renal Insufficiency
Histology

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Defronzo, R. A., Cooke, C. R., Wright, J. R., & Humphrey, R. L. (1978). Renal function in patients with multiple myeloma. Medicine, 57(2), 151-166.

Renal function in patients with multiple myeloma. / Defronzo, Ralph A; Cooke, C. R.; Wright, J. R.; Humphrey, R. L.

In: Medicine, Vol. 57, No. 2, 1978, p. 151-166.

Research output: Contribution to journalArticle

Defronzo, RA, Cooke, CR, Wright, JR & Humphrey, RL 1978, 'Renal function in patients with multiple myeloma', Medicine, vol. 57, no. 2, pp. 151-166.
Defronzo RA, Cooke CR, Wright JR, Humphrey RL. Renal function in patients with multiple myeloma. Medicine. 1978;57(2):151-166.
Defronzo, Ralph A ; Cooke, C. R. ; Wright, J. R. ; Humphrey, R. L. / Renal function in patients with multiple myeloma. In: Medicine. 1978 ; Vol. 57, No. 2. pp. 151-166.
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