Bear R A, Cole E H, Lang A, Johnson M
Can Med Assoc J. 1980 Oct 18;123(8):750-3.
Severe renal insufficiency is considered to indicate a poor prognosis in patients with multiple myeloma, their reported median survival being approximately 2 months. In five consecutive patients with severe renal failure secondary to acute myeloma kidney early aggressive therapy, including chemotherapy and peritoneal dialysis, led to a significant improvement in the renal function of four; the fifth patient received a cadaveric renal transplant after 1 year of peritoneal dialysis. After a median follow-up period of 12 months all the patients were alive and had improved renal function. This experience contrasts with that previously reported and suggests that aggressive management may improve the survival of patients with acute renal failure due to myeloma kidney.
严重肾功能不全被认为提示多发性骨髓瘤患者预后不良，据报道其平均生存期约为2个月。在连续5例继发于急性骨髓瘤肾病的严重肾衰竭患者中，早期积极治疗，包括化疗和腹膜透析，使4例患者的肾功能得到显著改善；第5例患者在腹膜透析1年后接受了尸体肾移植。经过12个月的中位随访期，所有患者均存活且肾功能有所改善。这一经验与先前报道的情况形成对比，提示积极治疗可能改善骨髓瘤肾病所致急性肾衰竭患者的生存率。
