Light chain-related tubulointerstitial nephropathy

  • Paul W. Sanders
  • Guillermo A. Herrera
  • John H. Galla
Part of the Developments in Nephrology book series (DINE, volume 22)

Abstract

Renal failure remains a major complication of multiple myeloma, occurring in about half of the patients with this disease; its presence is associated with a markedly shortened patient survival [1, 2, 3]. Although several different renal lesions may develop, the one most commonly recognized is a tubulointerstitial nephropathy often referred to as ‘myeloma kidney’ [1]. The characteristic features of this lesion include proximal tubule damage with atrophy and distal nephron cast formation. Bence Jones proteins (BJP), which are immunoglobulin LC’s in monomeric, dimeric, and aggregated forms, have been shown to be the most important association with renal failure [4, 5]. Also parenteral administration of LC’s has reproduced this tubulointerstitial lesion in mouse and rat models.

Keywords

Multiple Myeloma Proximal Tubule Proximal Convoluted Tubule Distal Nephron Bence Jones Protein 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Martinez-Maldonado M, Yium J, Suki WN, Eknoyan G. Renal complications in multiple myeloma: pathophysiology and some aspects of clinical management. J Chron Dis 1971; 24:221–37.PubMedCrossRefGoogle Scholar
  2. 2.
    Alexanian R, Balcerzak S, Bonnet JD, Gehan EA, Haut A, Hewlett JS, Monto RW. Prognostic factors in multiple myeloma. Cancer 1975; 36: 1192–1201.PubMedCrossRefGoogle Scholar
  3. 3.
    Kyle RA: Multiple Myeloma. Review of 869 cases. Mayo Clin Proc 1975; 50: 29–40.PubMedGoogle Scholar
  4. 4.
    Defronzo RA, Humphrey RL, Wright JR, Cooke CR: Acute renal failure in multiple myeloma. Medicine (Baltimore) 1975; 54: 209–23.CrossRefGoogle Scholar
  5. 5.
    Defronzo RA, Cooke CR, Wright JR, Humphrey RL. Renal function in patients with multiple myeloma. Medicine (Baltimore) 1978; 57: 151–66.Google Scholar
  6. 6.
    Weis JH, Williams RH, Galla JH, Gottschall JL, Rees ED, Bhathena D, Luke RG. Pathophysiology of acute Bence Jones protein nephrotoxicity in the rat. Kidney Int 1981; 20: 198–210.CrossRefGoogle Scholar
  7. 7.
    Sanders PW, Herrera GA. Galla JH. Human Bence Jones protein toxicity in rat proximal tubule ephithelium in vivo. Kidney Int 1987; 32 (in press).Google Scholar

Copyright information

© Kluwer Academic Publishers, Dordrecht 1988

Authors and Affiliations

  • Paul W. Sanders
    • 1
  • Guillermo A. Herrera
  • John H. Galla
  1. 1.Nephrology Research and Training Center, Division of Nephrology, Department of Medicine and PathologyUniversity of Alabama at BirminghamBirminghamUSA

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