Severe renal failure in multiple myeloma.

Twenty-four patients with multiple myeloma and renal failure severe enough to require dialysis were retrospectively analyzed. Most patients initially presented with renal failure and multiple myeloma was subsequently diagnosed. Intravenous pyelography precipitated irreversible renal failure in 2 patients. Absence of light chain disease and treatment with peritoneal dialysis were associated with increased recovery of renal fraction. The one year survival rate of myeloma patients on chronic dialysis was similar to the general myeloma population but was much worse than a group of age matched non-myeloma chronic dialysis patients. Survival rate was diminished in patients with elevated serum calcium levels.