Renal complications of multiple myeloma

In connection with the analyses of 84 post-mortem examinations (47 men, 37 women, average age: 66.3 years) the author dealt with the renal complications of multiple myeloma. The signs of cylinder nephropathy, light-chain nephropathy, amyloidosis, nephrocalcinosis, urate nephropathy, acute renal insufficiency, renal vein thrombosis, acute and chronic pyelonephritis as well as the tumorous infiltration of the renal tissue have been sought for. The severity of the lesions were ranged into minimal, slight, moderate, and severe groups. On the basis of the semiquantitative morphological picture and the clinical data: 1. intact kidney (41 patients), 2. involvement of the kidney without azotemia (10 patients), 3. involvement of the kidney with azotemia (17 patients, serum creatinine level: greater than 177 mumol/l) and 4. renal involvement with chronic renal insufficiency associated with uremia (16 patients) were discerned. In the background of 33 cases (39%) with deteriorated renal function cylinder nephropathy was found most frequently (27 occasions) (32%). Every other complication occurred significantly less frequently e.g. amyloidosis or kappa-light-chain nephropathy occurred in 3 cases each.