文献报道多发性骨髓瘤合并肾脏损害者可达60～90%;且肾功衰竭是仅次于感染的最常见的死亡原因。Allen报告骨髓瘤有43%死于肾功衰竭。但如能早期发现,有些肾脏的损害是可以预防和治疗的。此外有时骨髓瘤的临床表现极不明显甚至缺如,而肾脏损害突出。为此本文就骨髓瘤的肾脏合并症的病理、生理以及产生肾功衰竭的诱发因素,和其预防治疗等问题作一综述。一、多发骨髓瘤肾脏损害的病理生理和表现:肾损害可由于骨髓瘤本身所致,亦可继发于其他因素,现详述于下。(一)蛋白尿和凝溶蛋白尿:蛋白尿的发 Reported in the literature multiple myeloma with renal damage up to 60 to 90%; and renal failure is the second most common cause of death after infection. Allen reported that 43% of myeloma died of kidney failure. However, if early detection, some of the kidney damage can be prevented and treated. In addition sometimes the clinical manifestations of myeloma is very obvious or even missing, and prominent renal damage. Therefore, this article reviews the pathology and physiology of renal complications of myeloma and the inducing factors of renal failure, and its prevention and treatment. First, the pathophysiology of multiple myeloma kidney damage and performance: kidney damage due to myeloma itself, may also be secondary to other factors, are described in detail below. (A) proteinuria and coagulation proteinuria: hair proteinuria