Rabb H, Gunasekaran H, Gunasekaran S, Saba S R
Division of Nephrology, Hennepin County Medical Center, Minneapolis, MN 55415, USA.
Am J Kidney Dis. 1999 Feb;33(2):E5. doi: 10.1016/s0272-6386(99)70326-4.
Renal failure in multiple myeloma can be precipitated during hemodynamic perturbances of renal blood flow, as seen secondary to volume depletion, radiocontrast dye, and nonsteroidal anti-inflammatory agents. We report two cases of acute renal failure that developed suddenly after initiation of angiotensin-converting enzyme (ACE) inhibitor, both with biopsy-proven cast nephropathy. ACE inhibitors may contribute to the intratubular light chain cast formation and acute "myeloma kidney" in susceptible patients.
多发性骨髓瘤患者的肾衰竭可在肾血流动力学紊乱时诱发，如继发于容量耗竭、放射造影剂和非甾体类抗炎药。我们报告两例急性肾衰竭病例，均在开始使用血管紧张素转换酶（ACE）抑制剂后突然发生，两者均经活检证实为管型肾病。ACE抑制剂可能促使易感患者肾小管内轻链管型形成及急性“骨髓瘤肾病”。
