Kiran Aamir, Hina Abbas, Muhammad Hanif, Khalid Zafar Hashmi.
Frequency of Multiple Myeloma in Adult Patients Presenting with Acute Renal Failure.
Int J Pathol Jan ;15(4):161-6.

Hematological malignancies cause the renal impairment in unusual ways. There can be directly invasion by the malignancy, or the tumor cells act indirectly via immunologically mediated mechanisms. Multiple myeloma accounts for almost 10% of all hematological malignancies. Multiple myeloma frequently involves kidney and thus a significant cause of renal failure in the adult patients. Renal failure occurs in more than 50% of MM patients. Literature shows that renal failure is reversible in 25 to 58% of patients with supportive and anti-myeloma treatment. The aim of present study is to provide data on the frequency of multiple myeloma in adult patients presenting with acute renal failure which will aid clinicians to develop plan for all myeloma patients with ARF, so that could be done to minimize the morbidity and mortality. Objective: To determine the frequency of multiple myeloma in adult patients presenting with acute renal failure Patients and Methods: It is a Cross Sectional-Descriptive study conducted for a duration of 6 month at Sindh Institute of Urology and Transplantation, Karachi. we analyzed 217 patients of age 40 or above presenting with acute renal failure. The Patients unwilling for bone marrow examination, Patients of age less than 40 years, Diagnosed cases of multiple myeloma, surgical causes of acute renal failure were excluded from the study. Diagnosis of Multiple myeloma was diagnosed by at least two or more of the following features (1) more than 10% plasma cells in marrow aspirate. (2) serum or urine monoclonal band (3) Bence Jones proteinuria (4) lytic bone lesions Results: Out of these 217 cases 15(6.9%) were diagnosed as multiple myeloma. Mean age of patients was 57.27 ± 10.55 years. The clinical manifestations of myeloma included; anemia (93%), lytic bone lesions (100%), Bence Jones proteinuria (93%), Monoclonal peak in serum electrophoresis (87%), "M" peak in urine electrophoresis (93%). The precipitating factors of ARF identified were also identified. Conclusion: Multiple myeloma should be considered as cause of unexplained ARF in middle aged and elderly patients.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals -