Das, Pratik
July 2007
Indian Journal of Nephrology;Jul-Sep2007, Vol. 17 Issue 3, p128
Academic Journal
Aim: To evaluate the effect of high flux dialysis and plasma pheresis on renal recovery of myeloma cast nephropathy and to compare them with conventional low flux dialysis Materials and Methods: 16 patients of light chain myeloma with cast nephropathy and ARF were divided into three groups. Group I consisting of 6 patients received HD 3 per week with high flux polysulphone dialyser, Group II consisting of 6 patients received 3 per week HD with conventional F6 polysulphone dialyser and Group III consisting of 4 patients received 3 per week HD using F6 polysulphone dialyser combined with alternate day plasma exchange. All three groups received VAD based chemo therapy. Demographic profiles and comorbidities are similar in all the three groups. Reassessment in terms of dialysis requirement, serum creatinine and light chain level were evaluated at 4,8 and 12 weeks. Comparative analysis was done in between the groups. Resutls: In Group I, 1 patient at 4 weeks, 3 patients at 8 weeks and all 6 patients at 12 weeks became dialysis independent with mean creatinine of 2.1 mg/dl at 12 weeks. In Group II, none at 4 weeks, 1 at 8 weeks and only 3 at 12 weeks became dialysis independent and the mean creatinine of all the patients were 5.6 mg/dl at 12 weeks. In Group III, 1 patient died at 4 weeks, plasma exchange stopped at 4 weeks in 2 patients (due to financial reasons), they became dialysis independent at 12 weeks, 1 patient became dialysis independent at 8 weeks and plasma exchange discontinued. Mean creatinine at 12 weeks was 2.2 mg/dl. Cost of therapy was much higher in Group III. Conclusion: Use of high flux dialyser enhances light chain removal and tumour burden and there by enhances renal recovery in myeloma cast nephropathy compared to conventional dialysis using F6 polysulphone dialyser with or without plasma exchange.


Related Articles

  • Early detection of acute renal failure by serum cystatin C. Herget-Rosenthal, Stefan; Marggraf, Günter; Hüsing, Johannes; Göring, Frauke; Pietruck, Frank; Janssen, Onno; Philipp, Thomas; Kribben, Andreas // Kidney International;Sep2004, Vol. 66 Issue 3, p1115 

    Early detection of acute renal failure by serum cystatin C. Background. Acute renal failure (ARF) is associated with high mortality. Presently, no specific therapy for ARF exists. Therefore, early detection of ARF is critical to prevent its progression. However, serum creatinine, the standard...

  • ACUTE RENAL FAILURE IS A PRESENTING MANIFESTATION OF MULTIPLE MYELOMA: ANALYSIS OF 20 CASES. Prakash, Jai; Niwas, Shashidhar Shree; Parekh, Aashish; Vohra, Rubina; Wani, I. A.; Sharma, Naveen; Usha // Indian Journal of Nephrology;Jul-Sep2007, Vol. 17 Issue 3, p113 

    Background: Multiple myeloma (MM) is a commonly encountered hematological malignancy with significant renal involvement and often presents as renal dysfunction. The aim of present study is to analyse clinical spectrum of acute renal failure (ARF) in patients with MM. Materials and Methods: We...

  • Review: Fenoldopam reduces acute kidney injury and death in critical illness. Landoni, G.; Biondi-Zoccai, G. G.; Tumlin, J. A. // ACP Journal Club;May/Jun2007, Vol. 146 Issue 3, p58 

    The article presents a study which identifies the beneficial impact of fenoldopam in critically ill patients with or at risk for acute renal failure (ARF). It was noted that fenoldopam reduced risks for ARAF, requirement for renal replacement therapy, and all-cause mortality. The drug was...

  • Laboratory prediction of the requirement for renal replacement in acute falciparum malaria.  // Malaria Journal;2011, Vol. 10 Issue 1, p217 

    The article reports on the importance of renal replacement therapy (RRT) for adults with severe malaria. It states severe malaria can cause acute renal failure, for which RRT is important. It reports on the analysis of the data from two intervention studies in adults with severe malaria and...

  • Impaired Renal Function in Multiple Myeloma. Petra, Dorina; Oltean, G. // Acta Medica Marisiensis;Dec2010, Vol. 56 Issue 6, p538 

    Objectives: Impaired renal functions is present in multiple myeloma in more than 20% of patients. We propose to present characteristics of patients, the incidence of renal impairment, the degree of impairment and reversibility of renal function. Material and method: The study analyses 96...

  • In severe acute kidney injury, a higher serum creatinine is paradoxically associated with better patient survival. Jorge Cerdá; Magdalena Cerdá; Patricia Kilcullen; Jayne Prendergast // Nephrology Dialysis Transplantation;Oct2007, Vol. 22 Issue 10, p2781 

    Lack of precise, reliable and consistent measures of kidney dysfunction in acute kidney injury (AKI) causes uncertainty in the definition and management of this important condition and interferes with treatment standardization. Serum creatinine (SCr) remains a key determinant in the management...

  • Online high-efficiency haemodiafiltration achieves higher serum free light chain removal than high-flux haemodialysis in multiple myeloma patients: preliminary quantitative study. Granger Vallée, Alexandre; Chenine, Leila; Leray-Moragues, Hélène; Patrier, Laure; Cognot, Chantal; Cartron, Guillaume; Cristol, Jean-Paul; Canaud, Bernard // Nephrology Dialysis Transplantation;Nov2011, Vol. 26 Issue 11, p3627 

    Background. Fast reduction of serum free light chain (FLC) levels correlate with renal recovery in cast nephropathy. Because convection has the capacity to remove proteins of higher molecular weights, we hypothesized that haemodiafiltration (HDF) would be superior to haemodialysis (HD) for FLC...

  • Current therapeutic strategies for acute kidney injury. Negi, Shigeo; Shigematsu, Takashi // Clinical & Experimental Nephrology;Oct2012, Vol. 16 Issue 5, p672 

    Acute kidney injury (AKI) is characterized by a rapid decrease in kidney function and increased serum creatinine. The term acute renal failure (ARF) has been applied to such clinical manifestations. Despite several advances in the treatment of ARF, such as pharmacologic treatment and renal...

  • Controlled plasma exchange trial in acute renal failure due to multiple myeloma. Zucchelli, Pietro; Pasquali, Sonia; Cagnoli, Leonardo; Ferrari, Giuseppe // Kidney International;Jun1988, Vol. 33 Issue 6, p1175 

    We studied 29 patients affected by acute renal failure due to multiple myeloma with Bence-Jones proteinuria > 1 g/day to evaluate the effectiveness of plasma exchange in the treatment of severe myeloma nephropathy. Renal failure was severe enough to require dialysis in 24 cases, while the...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics