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Nephrology Dialysis Transplantation, Vol 13, Issue 90007 30-32, Copyright © 1998 by Oxford University Press

ORIGINAL ARTICLES

Renal impairment in myeloma: time for a reappraisal?

N Mallick, A Olujohungbe and M Drayson
Department of Renal Medicine, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK; Corresponding author

It is generally considered that a patient with myeloma who also has established renal impairment is unlikely to do well. While this is sometimes the case, analysis of recent data shows: (a) of 2768 patients in the MRC database for the fourth to the sixth trials, 10/163 with serum creatinine 300-600 &mgr;m/l and 20/89 with serum creatinine 600 &mgr;/l at presentation had renal failure as a recorded presenting feature, whatever the renal function, the most common presenting feature was bone pain; (b) that many patients have persisting evidence of reduced renal function yet survive for more than the median time of 36 months which applied to myeloma generally. Patients with renal impairment, especially those whose myeloma is brought to plateau by chemotherapy, should be assessed thoroughly for evidence of other than myeloma induced renal damage as both renovascular disease and prostatic obstruction in males are common in the elderly population at risk.
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