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November 1982

Reversible Renal Insufficiency in Multiple Myeloma

Author Affiliations

From the Departments of Internal Medicine, University of Michigan and Veterans Administration Medical Center, Ann Arbor.

Arch Intern Med. 1982;142(12):2083-2086. doi:10.1001/archinte.1982.00340250041008

• Forty-five patients met the criteria for the diagnosis of multiple myeloma in a retrospective chart review from 1975 to 1980. Renal insufficiency with peak serum creatinine concentration greater than 1.5 mg/dL involved 69% of all patients. Renal insufficiency was reversible in 55% of the cases. Treatment of hypercalcemia and/or chemotherapy for multiple myeloma was associated with reversibility in 88% of cases. Once renal insufficiency occurred in patients with multiple myeloma, those with reversible renal failure had a duration of survival fourfold longer (11.4 v 2.8 months) than those with Irreversible renal insufficiency. In conclusion, reversible renal insufficiency from hypercalcemia or the myeloma process itself develops in a majority of patients with multiple myeloma. If therapy reverses the renal dysfunction, a greater life expectancy occurs. Patients with multiple myeloma and renal insufficiency should, therefore, be examined for reversible causes of renal dysfunction, since if found and treated, a substantial improvement in prognosis is achieved.

(Arch Intern Med 1982;142:2083-2086)