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.