[Kidney lesion in multiple myeloma].

The authors have analysed the difficulties of delayed diagnosis of multiple myeloma (MM) with renal lesion in 27 patients admitted to the clinic of therapy and occupational diseases of the I.M. Sechenov First Moscow Medical Institute over the last 10 years. Before admission to the clinic MM was presumably diagnosed in 6 patients only, 17 patients were referred to the clinic with the diagnosis of this or that renal disease, 3 with the diagnosis of hypertension and 1 with rheumatoid arthritis. The main symptom in all the patients was proteinuria (isolated or combined with raised ESR and/or anemia in scanty urinary sediment). Macrohematuria was occasionally noted in one patient at the onset of the disease, and in another patient the onset of MM was marked by tubulopathy. The correct recognition of MM with renal lesion was rare which was due to a variety of initial symptoms (sometimes they were poorly expressed) and underestimation of the diagnostic importance of the combination of proteinuria with raised ESR and/or anemia.