Myeloma nephropathy

Kidney damage – myeloma nephropathy – the most frequent and serious manifestation of paraproteinemia . Chronic renal failure (CRF) ranks second among the causes of death in patients with MM, after infectious complications .

The study of the condition of the bronchopulmonary system in chronic renal failure is of particular importance. A.P. Zilber (1996) considers that there is no such system, to whose work the lungs would have no direct relation . There is a known relationship between the lungs and the kidneys, which is based on their participation in the regulation of many metabolic reactions . And when decompensating the functions of the kidneys, the lungs assume a significant part of the lost functions. Morphologically, lung lesions were detected at autopsies in 39-100% of patients who have depleted CRF .

There was a discrepancy between the severity of morphological changes in the lung tissue and the scarcity of clinical manifestations, often asymptomatic forms of the disease. Many authors share changes in the lungs with uraemia into three types: 1) specific for renal failure, 2) pulmonary edema due to overhydration, 3) bacterial pneumonia.

Specific lesion of the lung tissue arising from renal failure has several names: uremic pneumonia, uremic lung, uremic pneumonitis. Taking into account that peculiar changes in alveolar septa and vessels dominate, uremic pneumonitis reflects the nature of the pathological process more accurately than others and has recently been used most widely in the literature . Uncomplicated uremic pneumonitis has no clear clinical signs, and therefore the development of methods for its intravital registration is a highly relevant task. . For research purposes, Milne et al. (1995) conducted an independent study: 216 chest radiographs; 61 patients with cardiac disease, 30 with renal insufficiency and 28 with capillary edema permeability. The total diagnostic error in this study ranges from 86% to 89%. The highest accuracy was obtained in the diagnosis of capillary edema permeability (91%), and the lowest in distinguishing chronic rheumatic heart disease from uremic valve injury (81%).

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