多发性骨髓瘤肾功能损伤的研究进展

 多发性骨髓瘤（MM）是浆细胞的恶性肿瘤，肾功能损伤是多发性骨髓瘤的常见并发症。轻链蛋白在肾小管内沉积，形成骨髓瘤管型肾病被认为是重要的病理基础。针对MM患者，应评估肾小球滤过率，评价其肾功能损伤程度。硼替佐米联合大剂量地塞米松可用于治疗伴发肾功能损伤的骨髓瘤，可改善大多数患者的肾功能。尽管沙利度胺治疗经验有限，但可以对伴发肾衰竭的患者使用标准剂量的治疗。根据肾功能情况减量使用雷利度胺，对骨髓瘤患者是有效的，可逆转部分骨髓瘤患者的肾功能损伤。

Progress of renal damage from multiple myeloma

Multiple myeloma is a malignancy of plasma cells and renal function impairment is one of common complications of multiple myeloma.Light-chain deposition in renal tubules which induces renal tubular disease is the major pathogenesis of renal impairment.The renal function impairment should be estimated based on glomerular filtration rate in multiple myeloma patients. Bortezomib with high-dose dexamethasone is effective to myeloma patients with renal impairment and improves renal function.Treatment experience of thalidomide is limited,but it can be used at the standard dosage to patients with renal failure.Lenalidomide is effective and can reverse renal impairment of several myeloma patients when this agent is used at reduced doses according to renal function.