|
||||||||||||||||||||||||||||||||||||
| [
Contents
] [ INDEX ]
|
||||||||||||||||||||||||||||||||||||
| UDK 616.15-006.44-06 ; 616.61 |
ISSN 035-2899, 38(2013) br.1 p.40-49 |
|||||||||||||||||||||||||||||||||||
|
Review article Myeloma kidney: etiopathogenesis, diagnosis and therapy Mijelomski bubreg: etiopatogeneza, dijagnostika i lečenje Dejan Petrović (1), Predrag Đurđević (2), Biserka Tirmenštajn-Janković (3), Milenko Živanović (3) (1) KC „KRAGUJEVAC“, CENTAR ZA NEFROLOGIJU I DIJALIZU, KLINIKA ZA UROLOGIJU I NEFROLOGIJU, (2) KC „KRAGUJEVAC“, KLINIKA ZA HEMATOLOGIJU, (3) ZC „ZAJEČAR“, ZAJEČAR ODELJENJE ZA HEMODIJALIZU |
||||||||||||||||||||||||||||||||||||
|
|
||||||||||||||||||||||||||||||||||||
| Summary: Multiple myeloma is a malign disease of mononclonal plasma cells, which is characterized by an increased and uncontrolled proliferation of these cells in the bone marrow and an increased generation of monoclonal proteins. The goal of this work was to analyse the etiopathogenesis of the myeloma kidney and to point out the clinical importance of its early detection and timely treatment. Expert works and clinical studies with the subjects of etiopathogenesis, diagnostics and treatments of multiple myeloma and the myeloma kidney have been analysed. The multiple myeloma represents 10% of all hematological malign diseases. 50% of patients develop kidney damage: nephropathia caused by cylinders (the myeloma kidney), the light chain deposition disease and the amyloidosis of kidneys caused by the light chains. Monoclonal free light chains have direct cytotoxic effects on the epithelial cells of the proximal tubule and cause the creation and release of the proinflammatory cytokines in these cells, which cause the accumulation of mononuclear cells in the interstitium of the kidney and the revival of the tubuloinsterstitium. The reduction of the concentration of the monoclonal free light chains in the serum of the patient benefits to the recovery of the kidney function by more than 50% in the first three weeks. This reduction is achieved through the simultaneous usage of new chemotherapy agents (talidomid, bortezomib, lenalidomid, etc.) and therapy procedures for the direct removal of free light chains from the pa-tient's serum (plasmapheresis, HCO-hemodialysis). Early detection and timely treatment of multiple myeloma with acute kidney damage recovers the kidney function and improves life expectancy of these patients. Key words: multiple myeloma, myeloma kidney, treatment strategy Napomena: kompletan tekst rada na srpskom jeziku Note: full text in Serbian |
||||||||||||||||||||||||||||||||||||
|
|
||||||||||||||||||||||||||||||||||||
|
Corresponding Address: Dejan Petrović, Centar za nefrologiju i dijalizu, Klinika za urologiju i nefrologiju, KC Kragujevac, Zmaj Jovina 30, 34000 Kragujevac; Srbija; E-mail: aca96@eunet.rs |
Paper received: 28. 1. 2013 Paper accepted: 3. 4. 2013 Paper Internet issues: 15. 7. 2013 |
|||||||||||||||||||||||||||||||||||
| [
Contents
] [ INDEX ]
|
||||||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||
