大于50％多发性骨髓瘤(MM)患者发生肾功能不全,肾损害累及众多因子,但临床的、实验的和形态学研究提示轻链本身起主要的作用。最近认为血浆交换(PE)是迅速去除大量轻链最有效的方法,故结合碱性利尿、透析和化疗被用来处理重度肾功能不全。为了估价PE治疗重度骨髓瘤肾病的效果,作者对26例MM引起急性肾功能衰竭作设有对照组的研究。 Renal dysfunction occurs in more than 50% of patients with multiple myeloma (MM), and renal impairment involves many factors, but clinical, experimental and morphological studies suggest that the light chain itself plays a major role. Recently, plasma exchange (PE) is considered the most effective way to quickly remove large amounts of light chain, so combined with alkaline diuretic, dialysis and chemotherapy are used to treat severe renal insufficiency. To assess the efficacy of PE in the treatment of severe myeloma and nephropathy, the authors performed a study of 26 patients with MM-induced acute renal failure.