You mean I have cancer and my kidneys fail, myeloma kidney? Tell my fragile oncology patient at Bellevue shortly after a medical student told him his kidneys were damaged. Indeed, his new diagnosis of multiple myeloma is accompanied by admission cretonne.
About a
quarter of patients with multiple myeloma have renal failure at diagnosis?
There are a number of multiple myeloma clinic responses that occur in the
kidney and cause more often in a state called myeloma kidney, which is
specifically caused by a combination of renal disease and inflammatory cascades
myeloma fusion triggered by the presence of chains light in neuron tubules.
Besides myeloma kidney, renal function in multiple myeloma may be compromised
by hyperglycemia, acquired Francois syndrome, a disease of the presentation of
the light chain and associated light chain myeloid.
Myeloma
kidney: light chain proteins are normally freely filtered by the gloomier and
then benedictions in the proximal tubule and returned to the bloodstream. In
multiple myeloma, the reference mechanism becomes overwhelmed and light chains
form aggregates instead of Tammy -Hors fall protein in the distal tubule
myeloma kidney. The hyper variable region of the light chain is primarily
responsible for this interaction. Finally, add cylinders proteins block the
flow of urine and reduce glandular filtration rate. Furthermore, the light
chain benedictions causes many signaling cascades pro - inflammatory, such as
NF- kappa B and inflammatory changes long is excessive interstitial fibrosis
and renal tubular function.
The
hyperglycemia: Multiple myeloma is associated with excessive bone destruction
and osteopath-mediated resultant hyperglycemia, myeloma kidney which in turn
causes constriction of afferent arterioles in the kidney and a general loss of
volume. Together these mechanisms to improve the training of actors and also
aggravate the already tenuous, regardless of renal function in patients with
multiple myeloma.
Francois
syndrome: Humans produce two types of kappa and lambda light chains myeloma
kidney. In particular, kappa light chains can cause damage to the proximal
renal tubules and cause Francois syndrome. This failure condition is described
in proximal tubular rehabs option capacity and results in the second type renal
tubular acidosis, glucose, monoacid, pyrophosphate myeloma kidney, and
hypoglycemia.
Systemic
disorders: Finally, light chain deposition disease myeloma kidney, and a light
chain associated with systemic myeloid is a disease characterized by excess
deposition on fabric chains proteins and immunoglobulin light DC fibrillate
structures of N-terminal fragments of the regions variable light chains in AL.
Gloomier that are responsible for filtering the light chain protein, the kidney
is an important target for both light chains and N- terminal fragment of
presentation. As expected myeloma kidney, renal disease usually dominates the
clinical course of LCD. Light chains and fragments thereof are typically
deposited in the meantime of the gloomier, but may also be present in the
arterioles and capillaries myeloma kidney. Also, light chain N-terminal
fragments and altering the biochemistry of human mechanical cells in different
ways, which can be demonstrated microscopically by Congo red staining. N
-terminal fragments bind strongly to Congo red dye, causing a characteristic
apple green birefringence while light chains do not.
Renal
failure or hyperglycemia secondary to volume depletion can be resolved with
proper treatment. However, the reversibility of myeloma nephropathy continues
to generate much debate myeloma kidney, particularly regarding the
effectiveness of the plasma exchange therapy in the treatment of disease. A
2005 randomized controlled trial found no difference in the prognosis of
patients with myeloma cast nephropathy myeloma kidney, regardless of whether
they had received PLAX. However, a major criticism of this study is that
patients do not receive a kidney biopsy. No confirmation of tissue, it is
possible that in some patients, kidney failure may be secondary to LCD or AL,
both of which are perceived as irreversible condition. However, despite the
current controversy, many experts still recommend PLAX in certain circumstances
myeloma kidney.
In summary,
the excess light chains produced in multiple myeloma are the main
psychophysiology factor responsible for kidney damage myeloma kidney. Light
chains invade neuron tubules initiate inflammation and disturb the brush border
and glandular function. Hyperglycemia often compounds the problem. In summary,
the kidneys of patients with multiple myeloma are essentially powerless
spectators myeloma kidney. Only aggressive tumor treatment, hydration,
restricting radiological material, and if necessary, as a last option of a kidney,
the damage can be minimized.
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