The myeloma kidney is a life-threatening consequence of severe kidney damage from a cancer of the blood-forming system. It arises after a severe poisoning by proteins, which are formed by the so-called multiple myeloma. The deposition of this protein cylinder directly weakens the Nierenkanälchen, which can very quickly lead to acute renal failure.

What is a myeloma kidney?

Multiple myeloma is also known as plasmocytoma. It is characterized by the proliferation of plasma cells in the blood, which are responsible for the production of antibodies. These degenerate plasma cells produce cancer cells and produce antibodies that are identical to themselves. Multiple myeloma can progress slowly, but it can also be very fast and aggressive. From it the so-called myeloma kidney can emerge.

causes

Plasmocytoma is considered the most common malignant tumor in bone marrow and bone. However, he usually does not appear until after the age of 40 years. At the age of 60 years, the disease accumulates, in men more than in women.

Four to six new cases per 100, 000 inhabitants and year were measured. About every tenth haematological cancer is a multiple myeloma. It is estimated that in 2015, approximately 75, 000 people worldwide suffered from a plasmocytoma.

The specific factors that lead to a myeloma kidney have not yet been verified in medical research. It is believed that inheritance plays a role. There are also assumptions that ionizing radiation can have a major impact on the onset of the disease. Equally possible is a damaging influence of the plant protection agent glyphosate, which comes about through the diet.

Symptoms, complaints & signs

After a malignant plasma cell has increased clonally, it damages the bone marrow and negatively affects blood formation. Gradually, the affected bone can be destroyed and degraded. These massive bone changes are prominent in around 60 percent of patients.

In addition, the malignant cells form defective, very aggressive antibodies or antibody parts (light chains), which cause further complications of the disease in the body. The natural immune defense is thus severely impaired. Larger tissue deposits can lead to serious functional failures of various organs.

These include kidney failure, but also severe irregularities in the entire blood circulation. As the protein content increases, the blood becomes significantly more viscous. Smallest blood vessels can easily clog and especially the brain is poorly supplied with blood.

Initially, sufferers initially perceive disorders of hearing and vision or slight fainting fits. Primarily, the unnatural growth of plasma cells leads to bone pain and later minor bone fractures. The calcium in the blood increases greatly due to the release from the bone. The red blood cells formed in the bone marrow decrease drastically.

Diagnosis & disease course

The diagnosis can often be made only under unclear conditions, because the suffering leads far beyond damage to the kidney. In the early stages of multiple myeloma, misdiagnosis sometimes occurs, as the underlying symptoms are suspected of renal hypersensitivity, rheumatism, sprain, or bone decalcification (osteoporosis).

The examination of the blood illustrates a so-called fall of the white blood cells. Their share in the blood decreases with strikingly high speed. The blood picture often shows a considerable anemia. Also, the number of platelets can be significantly reduced.

In patients with already progressive bone loss, the calcium level increases unnaturally. Possible damage to the kidney can be read relatively well on altered kidney values. Due to the lack of antibodies due to the malformations of the plasma cells, the susceptibility of patients for a variety of infections increases.

This is often accompanied by a generally perceived physical weakness and a more or less pronounced weight loss. Also, headache, nausea, dizziness, as well as debilitating drowsiness are often encountered. The light chains (antibody parts) resulting from the inadequate multiplication of the diseased plasma cells are often deposited in the renal corpuscles and renal tubules.

Thus, there is an increased excretion of protein in the urine, which is then missing in the blood. Because malfunctions of the kidney become noticeable, for example, acids are excreted to a reduced degree. In contrast, deficiencies of phosphate, glucose, uric acid and amino acids arise.

complications

The myeloma kidney is a life-threatening disease. If not treated directly, the worst case scenario may be renal insufficiency and, eventually, premature death of the patient. The life expectancy of the person affected is significantly reduced by this disease. Likewise, the immune system of the patient is significantly weakened, so it comes more often to inflammation and infection.

In addition, the internal organs can be severely damaged and decline in their function. The blood flow of the body takes place only irregularly and it also comes to a greatly reduced blood flow to the brain. The affected people often lose consciousness and can injure themselves. Furthermore, the myeloma kidney leads to bone fractures and thus to a strong reduction in the quality of life of the patient.

Reduced blood flow to the brain can also lead to paralysis and irreversible damage to the entire body. The treatment itself is performed by chemotherapy or stem cell transplantation. However, chemotherapy can cause a variety of side effects. Although the treatment can usually reduce but not completely resolve the symptoms, the patient's life expectancy is always reduced by the myeloma kidney.

When should you go to the doctor?

Patients who are already receiving medical treatment for renal damage should report to a doctor for an increase in symptoms or a further deterioration in overall health. In addition to the scheduled checks, a visit to the doctor for pain, disorders of the immune system, an increased susceptibility to infections or a decrease in performance is necessary.

If it comes to disturbances of consciousness or a loss of consciousness, an ambulance service is needed. First aid measures are to be taken so that the survival of the person concerned is ensured. General dysfunctions of the organism are alarming and must be presented immediately to a doctor. Therefore, there is a need for action in the case of diminished vision or hearing loss.

In case of abnormalities of the urine, discoloration, changes in the amount or smell, a doctor should be consulted. Fatigue, rapid fatigue and increased sleep requirements are signs of an irregularity. If it comes to headaches, a loss of weight and circulatory disorders, seek medical advice. A decrease in concentration and attention, apathy and withdrawal from social life should be discussed with a physician. Nausea, gait uncertainty and dizziness are also unusual and can be clarified. A pale complexion, cold fingers and toes, and a quick sense of coldness can be an indication of a health condition that needs to be treated.

Treatment & Therapy

A fundamental cure of multiple myeloma is not possible with the previously known medical procedures. If no symptoms are present, the course of the disease is initially observed. These include regular bone marrow examinations and various laboratory tests.

A drug or anti-cancer therapy is only initiated when significant bone changes are going on. The condition of the patient can now be kept stable for six to ten years with several possible treatment methods and his quality of life can be maintained at an acceptable level.

Chemotherapy is carried out according to a classical pattern, whereby side effects can be suppressed extremely effectively with the help of the latest medication. The tendency of the malignant cells to divide can also be conventionally blocked with localized radiotherapy.

Furthermore, a so-called autologous stem cell transplantation is possible in which stem cells from the patient's own bone marrow are used. They can regenerate blood formation after a short time. Much less frequently is allogeneic stem cell transplantation used, in the framework of which foreign stem cells should form a completely new blood formation system.

Here, however, the rejection must be suppressed over a period of about a year with the help of medication. However, stem cell transplantations are not suitable at an older age.

Outlook & Forecast

A myeloma kidney can be treated relatively well. The exact prognosis depends on different factors. First of all, it is important to know if the condition is related to a chronic kidney disease or an independent disease. The prognosis is positive if treatment is initiated early. Above all, a myeloma kidney due to the glomular light chain disease can be treated well with the appropriate medication. In patients with AL amyloidosis, the prognosis is worse because the deposits remain in the body for a long time. In the worst case, there is a kidney failure and thus the death of the patient.

If left untreated, a myeloma kidney often dies fatal. The patient is increasingly experiencing discomfort that eventually leads to organ failure. Thereafter, immediate treatment is required, otherwise the patient will die as a result of the myeloma kidney and the resulting renal failure. The patients have a limited life expectancy. Prognosis can be improved by early consultation with a nephrologist or other specialist who can initiate treatment according to the symptoms. If this happens in time, the quality of life can be preserved. Nevertheless, long-term discomfort can occur, which are to be treated individually. Especially the typical signs of poisoning should be treated comprehensively.

prevention

Since the causes of a myeloma kidney could not be clarified so far, there are no precautionary measures. In principle, contact with known risk factors such as ionizing radiation or pesticides and other carcinogenic substances should be avoided.

aftercare

In most cases, patients with a myeloma kidney have very few and limited immediate aftercare measures available, so this disease requires first and foremost a quick and, above all, early diagnosis. Therefore, patients should consult a doctor at the first symptoms and signs of the disease to prevent the occurrence of other complications and complaints.

The sooner a doctor is visited, the better is usually the further course of the disease. In most cases, those affected by the myeloma kidney are dependent on chemotherapy, which can alleviate the symptoms. During therapy, comprehensive support from one's own family is very important to prevent depression and other mental disorders.

Most sufferers are dependent on the care of other people in their everyday lives. Regular checks and examinations by a doctor are very important in order to detect and treat further complaints at an early stage. The myeloma kidney reduces the life expectancy of the patient in most cases and can not be completely cured.

You can do that yourself

A myeloma kidney can not yet be treated causally. The most effective self-help measure focuses on alleviating the symptoms. The patient should consult the physician closely and follow the physician's instructions to avoid complications.

The pain can often be reduced by natural remedies such as valerian or arnica. The typical malady can be alleviated by moderate exercise and a well-adjusted diet. During and after radiation therapy, rest and bed rest apply. The patient must take the necessary measures to support healing and eliminate risks. This can be done by identifying any risk factors. Here, in cooperation with the doctor, a complaint diary can be created.

After the treatment has been completed, further checkups are indicated. The person concerned should regularly visit a specialist clinic for kidney diseases, so that the organ can be examined for possible recurrences. If unusual symptoms or symptoms develop, the doctor must be informed.

Since a myeloma kidney is often a long-term disease that puts a lot of strain on those affected, a psychological consultation is also advisable in addition to the medical treatment. If desired, the therapist can also establish contact with a self-help group for the chronically ill.

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