51338
document
Treatment of renal failure associated with multiple myeloma . Plasmapheresis , hemodialysis , and chemotherapy . The aims of this study were to examine in a prospective , randomized trial the efficacy of plasmapheresis in preventing irreversible renal failure in patients with multiple myeloma and to study the renal biopsy tissues from such patients . Twenty-one patients with active myeloma and progressive renal failure were randomized to one of two groups : group 1 , forced diuresis and chemotherapy ( 10 patients ) , and group 2 , forced diuresis , chemotherapy , and plasmapheresis ( 11 patients ) . Plasmapheresis and chemotherapy lowered the serum myeloma protein value much more rapidly than chemotherapy alone . Of 5 patients who were oliguric and undergoing dialysis at presentation , only 3 who were treated by plasmapheresis recovered . Of 16 polyuric patients , 5 in group 1 and 7 in group 2 showed improvement in renal function . The main factor that determined irreversibility of renal failure was the severity of myeloma cast formation .
51339
Intervention_Pharmacological
forced
51340
Intervention_Physical
diuresis
51341
Intervention_Pharmacological
chemotherapy
51342
Intervention_Pharmacological
forced diuresis
51343
Intervention_Pharmacological
chemotherapy
51344
Intervention_Physical
plasmapheresis
51345
Outcome_Physical
renal failure
51346
Outcome_Physical
irreversible renal failure
51347
Outcome_Physical
serum myeloma protein value
51348
Outcome_Physical
renal function
51349
Participant_Condition
renal failure
51350
Participant_Condition
multiple myeloma
51351
Participant_Sample-size
Twenty-one
51352
Participant_Condition
myeloma
51353
Participant_Sample-size
5
51354
Participant_Sample-size
16