Multiple myeloma -- blood cancer formed in bone marrow
Myeloma Side Effects — Renal Insufficiency
About half of patients with multiple myeloma have renal insufficiency, meaning their kidneys are not working as well as healthy kidneys. Kidney problems, including renal failure, are one of the many myeloma side effects.
By Madeline R. Vann, MPH
Medically Reviewed by Lindsey Marcellin, MD, MPH
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Half of all patients with multiple myeloma will experience renal insufficiency — kidneys that work less efficiently than they should. Many patients may not even know that their kidneys are struggling until a lab test reveals their renal insufficiency, one of the many myeloma side effects.
“In myeloma, there are abnormal plasma cells produced by the bone marrow,” explains Sagun Shrestha, MD, a hematologist and medical oncologist at the Cancer Treatment Centers of America at the Southwestern Medical Center in Tulsa, Okla. “These cancerous plasma cells start producing large proteins, called paraproteins, which are secreted in urine and blood and eventually can block the kidney.”
This causes a condition referred to as “myeloma kidney.” With the kidney blocked, it is difficult for the organ to carry out its job of filtering and cleaning the blood, producing urine to excrete waste, helping keep blood pressure normal, and controlling fluid levels in your body — all of which translate to renal insufficiency.
Shrestha says that most patients cannot feel it when their kidneys start to lose function. “Most of the time it’s in the blood work that we see the kidney function has become abnormal.” Symptoms of renal insufficiency that you might experience include producing less urine than normal, a swelling in the face or extremities — hands or feet, feeling nauseated, and vomiting.
Managing Renal Insufficiency
If you have multiple myeloma and have not yet developed renal insufficiency, one of the most important things you can do to reduce your risk is to stay hydrated. Consuming fluids helps move potential blockages out of your kidneys. Talk to your doctor about the appropriate amount to drink each day.
Because renal insufficiency is one of many myeloma side effects, kidney function can be improved with myeloma treatment, especially if the cancer treatment begins early in the course of the disease.
Another way to manage renal insufficiency involves dialysis, which is needed when the kidneys fail, a condition called renal failure. “If the kidney fails totally, that’s when the nephrologist comes in and does dialysis. Most patients do well on dialysis,” says Shrestha.
Preventing Additional Kidney Damage
The kidneys need special consideration when you have multiple myeloma. Shrestha emphasizes that renal insufficiency is a serious myeloma side effect that carries additional risks, and that the risks of renal insufficiency and renal failure should be well understood by the patient and by all the patient’s caregivers.
“If I see [patients with] early stages of renal insufficiency, I always tell them that whenever they go to another doctor, they have to make sure that any antibiotics or pain medications prescribed to them are not toxic to the kidneys,” says Shrestha.
Taking the wrong prescription medication or even the wrong contrast dye for a medical test can further damage the kidneys, Shrestha explains. Make sure all the health professionals on your team know that your kidneys are not working at 100 percent.
Renal insufficiency, though serious, can be managed through the treatment of myeloma and other steps. Work with your doctors to get your renal insufficiency under control and to protect your kidneys from further damage.
Video: Renal complications in multiple myeloma - characteristics and treatment
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