—Craig and Powell have provided convincing evidence that patients with multiple myeloma and light chain proteinuria are at risk for renal insufficiency from NSAID, most likely on the basis of overt or occult light chain nephropathy. Prostaglandins are involved in the compensatory response to renal injury or reduced renal mass from many causes, as we have recently discussed elsewhere.1 As noted by Craig and Powell, and illustrated by their case report, the risk in patients with myeloma is usually multifactorial (on the basis of advanced age, other medications, and so on).Whether or not all patients with multiple myeloma are at risk for renal insufficiency from NSAID is open to question. The experience with systemic lupus erythematosus, a systemic disease with renal involvement in
Blackshear JL, Davidman M, Stillman MT. Multiple Myeloma-Reply. Arch Intern Med. 1984;144(4):868. doi:10.1001/archinte.1984.00350160233050
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