Kes Petar, Basić-Jukić Nikolina, Jurić Ivana, Brunetta Bruna
Zavod za dijalizu, Klinicki bolnicki centar Zagreb, Zagreb.
Acta Med Croatica. 2008;62 Suppl 1:37-43.
Multiple myeloma (MM) is malignant disease caused by proliferation of malignant clone of terminally differentiated plasma-cells. Clinical features may include symptoms of bone disease, unexplained back-pain, fractures, anaemia, kidney failure, oedema, hypercalcaemia, bacterial infections, impaired hemostasis, peripheral neuropathy and hyperviscosity. Impairment of renal function occurs in 50% of patients with different forms of kidney disease. Majority of patients have precipitation of monoclonal immunoglobulins or their fragments in kidney. Hypercalcemia, dehydration, infections and nephrotoxic drugs contribute to development of kidney injury. Treatment consists of chemotherapy for primary disease, with plasma exchange in cases of hyperviscosity. Supportive treatment should include rehydration, treatment of hyperuricemia and hypercalcaemia. Patients with end-stage renal disease could be treated with peritoneal dialysis or haemodialysis. Renal transplantation is rarely offered to this group of patients.
多发性骨髓瘤（MM）是一种由终末分化浆细胞的恶性克隆增殖引起的恶性疾病。临床特征可能包括骨病症状、不明原因的背痛、骨折、贫血、肾衰竭、水肿、高钙血症、细菌感染、止血功能受损、周围神经病变和血液黏稠度增高等。50%患有不同形式肾脏疾病的患者会出现肾功能损害。大多数患者的肾脏中有单克隆免疫球蛋白或其片段沉淀。高钙血症、脱水、感染和肾毒性药物会促使肾损伤的发生。治疗包括针对原发性疾病的化疗，对于血液黏稠度增高的病例进行血浆置换。支持性治疗应包括补液、治疗高尿酸血症和高钙血症。终末期肾病患者可采用腹膜透析或血液透析进行治疗。很少为这组患者提供肾移植。
