| [ Summary ] |
Although as many as 50% of patients with multiple myeloma (MM) may experience some degree of renal insufficiency, in the majority renal function will improve in response to simple treatment for hypercalcemia or dehydration. Plasma exchange or plasmapheresis has heen proposed as a treatment for hyperviscosity syndrome and as a therapy for prevention of M protein-associated renal failure by removing M protein from plasma. Renal replacement therapy (RRT) such as hemodialysis (HD) and peritoneal dialysis (PD) has heen performed in MM patients with renal failure. However, the recovery rate in patients with renal failure enough to require RRT was low. Increased removal of M protein hy continuous ambulatory PD (CAPD) may increase the possibility of recovery of renal function, decrease the risk of hyperviscosity syndrome, and prevent the onset of amyloidosis. Lack of necessity for systemic heparinization in CAPD patients may reduce the risk of hemorrhagic complications in MM. However, peritonitis is the major problem in MM patients undergoing CAPD. HD and CAPD appeared to be equally effective treatments. Although the mean survival rate was shorter in patients requiring dialysis than in patients not on RRT, RRT provides a good quality of life for MM patients. |