THE BASIC MECHANISMS OF THE DEVELOPMENT OF RENAL-FAILURE AND METHODS OF ITS CORRECTION IN MULTIPLE-MYELOMA

To examine functional capacities of the kidneys, reserve potentialities of the urinary tract and the mechanism of the development of chronic renal failure (CRF) in multiple myeloma (MM), 60 patients were examined. In addition to the routine methods of examination, all the patients were subjected to renal sonography. It has been shown that the main causes of CRF in MM are proteinemia and paraproteinuria. Emphasis is laid on the importance of sonography that enables one to measure not only the size of the kidneys, to estimate the status of the parenchyma and calyceal system, but also to reveal the derangement of urodynamics of the upper urinary tract in the stage of latent CRF. It has been demonstrated that one of the effective methods of removing CRF lies in therapeutic plasmapheresis, which is advisable in MM patients even in latent renal failure, preventing the impairment of the tubular system and increasing the filtration and reabsorption capacity of the kidneys.