Plasmapheresis and hemodialysis in the treatment of acute renal failure in multiple myeloma.

Two patients with multiple myeloma (IgA-kappa and IgG-lambda) and severe acute renal failure were treated by combined plasmapheresis and hemodialysis. In both patients renal function was restored to normal. The pathogenetic role of M-proteins and the possible mechanisms responsible for renal damage were discussed. While the addition of plasmapheresis has not been shown to extend survival, a reduction in the need for long-term dialysis appears to result from this intervention. It is concluded that the removal of M-proteins by plasmapheresis may be of therapeutic value in multiple myeloma patients.