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多发性骨髓瘤出现急性肾功衰竭常被认为预后不良之征,一般主张用强制硷化利尿,透析和化学疗法。De Fronzo等新近报道,他们的14例患者仅5例肾功恢复,而其中13例在数月内死亡。作者认为,在少数情况下,某些因素如高钙血症,高尿酸血症,高粘滞综合征,淀粉样变性或浆细胞浸润间质,可引起本病中的肾功衰竭,而在多数病例中,本周氏蛋白尿的出现与肾功衰竭之间有明显的关系。实验也证明,“骨髓瘤肾”在产生典型的肾功损害方面,轻链起了病原学的作用。轻链易被肾小球滤过,大部分又被肾小管细胞重吸收和分解,剩余的排泄于尿中。在远端肾单位,由于轻链沉淀和管型梗
Emerging acute renal failure of multiple myeloma is often considered a sign of poor prognosis, and is generally advocated by mandatory alkalized diuretic, dialysis and chemotherapy. In a recent report by De Fronzo et al., Only 5 of 5 patients recovered in their 14 patients, and 13 of them died within months. In a few cases, the authors argue, certain factors such as hypercalcemia, hyperuricemia, hyperviscosity syndrome, amyloidosis or plasma cell infiltration can lead to renal failure in this disease, In most cases, there is a clear relationship between the appearance of this week’s proteinuria and renal failure. Experiments have also shown that “myeloma kidney” plays an etiologic role in the development of typical renal damage. Light chain is easily glomerular filtration, most of them reabsorption and decomposition of renal tubular cells, the remaining excreted in the urine. In the distal nephron, due to light chain precipitation and tubular stems