Myeloma kidney
| Classification according to ICD-10 | |
|---|---|
| C90.0 + | Plasmacytoma (multiple myeloma) |
| N08.1 * | Glomerular diseases in neoplasms - Glomerular diseases in plasmacytoma |
| N16.1 * | Renal tubulo-interstitial disease in neoplasms - Renal tubulo-interstitial disease in plasmacytoma |
| ICD-10 online (WHO version 2019) | |
The myeloma kidney or cast nephropathy (cast: English for cylinder) is the classic form of kidney damage in multiple myeloma . It is caused by a toxic effect of the proteins produced by multiple myeloma .
In the presence of Tamm-Horsfall protein , light chains in the kidney tubules can precipitate in the form of protein cylinders . These precipitates have a direct toxic effect on the cells of the kidney tubules and can lead to a rapid loss of kidney function and thus to acute kidney failure . Histologically , the myeloma kidney is characterized by the occurrence of protein cylinders in the distal tubule .
In around 40% of cases, acute kidney failure is the first clinical manifestation of multiple myeloma. Bence Jones proteinuria can be detected in the urine if a myeloma kidney is present . If in doubt, the diagnosis can be confirmed with the help of a kidney biopsy .
There are a total of three manifestations of multiple myeloma of the kidney:
- Myeloma kidney: histology: tubular damage by light chains. Clinic: tubular dysfunction, (GFR drop, renal insufficiency )
- Light chain nephropathy : histology: glomerular damage . Clinic: glomerular proteinuria , high blood pressure , renal insufficiency
- AL amyloidosis
Individual evidence
- ↑ T. Risler, K. Kühn: specialist in nephrology ; Urban & Fischer at Elsevier; 1st edition 2008; ISBN 3-437-23900-7 .
- ^ Information sheet from the Münster University Hospital .
