TY - JOUR
T1 - Multiple myeloma in end-stage renal disease
AU - Penfield, Jeffrey G.
PY - 2006/7
Y1 - 2006/7
N2 - Multiple myeloma is a common cause of chronic kidney disease (CKD). Patients with myeloma-related kidney disease but low levels of serum monoclonal proteins can be diagnosed with symptomatic myeloma in a simplified diagnostic classification. The presence and type of renal disease in myeloma is dependent on the light chain secreted. Treatment has recently changed and now includes the use of thalidomide and bisphosphonates. Thalidomide can cause hyperkalemia and bisphosphonates can cause renal failure in patients with CKD. Their use is not contraindicated, but they should be used with caution. High-dose melphalan with an autologous stem cell transplant is now the standard of care and should not be withheld from patients with CKD, even those on dialysis. This treatment can improve the renal disease, and this is more likely if treatment is started early. In patients with persistent dialysis dependence, renal transplantation can be performed if the patient has a complete remission.
AB - Multiple myeloma is a common cause of chronic kidney disease (CKD). Patients with myeloma-related kidney disease but low levels of serum monoclonal proteins can be diagnosed with symptomatic myeloma in a simplified diagnostic classification. The presence and type of renal disease in myeloma is dependent on the light chain secreted. Treatment has recently changed and now includes the use of thalidomide and bisphosphonates. Thalidomide can cause hyperkalemia and bisphosphonates can cause renal failure in patients with CKD. Their use is not contraindicated, but they should be used with caution. High-dose melphalan with an autologous stem cell transplant is now the standard of care and should not be withheld from patients with CKD, even those on dialysis. This treatment can improve the renal disease, and this is more likely if treatment is started early. In patients with persistent dialysis dependence, renal transplantation can be performed if the patient has a complete remission.
UR - http://www.scopus.com/inward/record.url?scp=33746237568&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33746237568&partnerID=8YFLogxK
U2 - 10.1111/j.1525-139X.2006.00181.x
DO - 10.1111/j.1525-139X.2006.00181.x
M3 - Review article
C2 - 16893412
AN - SCOPUS:33746237568
SN - 0894-0959
VL - 19
SP - 329
EP - 334
JO - Seminars in Dialysis
JF - Seminars in Dialysis
IS - 4
ER -