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[多发性骨髓瘤的肾脏并发症]

[Renal complications of multiple myeloma].

作者信息

Iványi B

出版信息

Orv Hetil. 1989 Sep 17;130(38):2041-4.

PMID:2797787
Abstract

In connection with the analyses of 84 post-mortem examinations (47 men, 37 women, average age: 66.3 years) the author dealt with the renal complications of multiple myeloma. The signs of cylinder nephropathy, light-chain nephropathy, amyloidosis, nephrocalcinosis, urate nephropathy, acute renal insufficiency, renal vein thrombosis, acute and chronic pyelonephritis as well as the tumorous infiltration of the renal tissue have been sought for. The severity of the lesions were ranged into minimal, slight, moderate, and severe groups. On the basis of the semiquantitative morphological picture and the clinical data: 1. intact kidney (41 patients), 2. involvement of the kidney without azotemia (10 patients), 3. involvement of the kidney with azotemia (17 patients, serum creatinine level: greater than 177 mumol/l) and 4. renal involvement with chronic renal insufficiency associated with uremia (16 patients) were discerned. In the background of 33 cases (39%) with deteriorated renal function cylinder nephropathy was found most frequently (27 occasions) (32%). Every other complication occurred significantly less frequently e.g. amyloidosis or kappa-light-chain nephropathy occurred in 3 cases each.

摘要

在对84例尸检(47例男性,37例女性,平均年龄:66.3岁)进行分析的过程中,作者研究了多发性骨髓瘤的肾脏并发症。寻找了管型肾病、轻链肾病、淀粉样变性、肾钙质沉着症、尿酸盐肾病、急性肾功能不全、肾静脉血栓形成、急慢性肾盂肾炎以及肾组织肿瘤浸润的迹象。将病变的严重程度分为轻度、中度和重度组。根据半定量形态学图像和临床数据:1. 肾脏正常(41例患者),2. 肾脏受累但无氮质血症(10例患者),3. 肾脏受累且有氮质血症(17例患者,血清肌酐水平:大于177μmol/L),4. 肾脏受累并伴有与尿毒症相关的慢性肾功能不全(16例患者)。在33例(39%)肾功能恶化的病例中,最常发现管型肾病(27例次)(32%)。其他并发症的发生频率明显较低,例如淀粉样变性或κ轻链肾病各发生3例。

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