How does myeloma affect the kidney? What causes kidney problems in myeloma? So it's actually a really interesting and complex question because multiple myeloma can affect your kidneys in a large number of ways. What is referred to as myeloma kidney is when the light chains kind of clog up the kidneys. We call this cas-nephropathy. It's a big word. And cas are a collection of materials that collect inside the collecting system of the kidneys. And nephropathy is fancy doctor words for abnormalities of the kidneys. So it's basically a part of those bad proteins that the myeloma cells make clogging up the kidneys so that they don't work. But myeloma can affect the kidneys in a large number of other ways. There's something else called deposition diseases. These are things like amyloidosis. So instead of those proteins kind of balling up and clogging up the collecting system, they can deposit inside the organ itself and cause problems that way. Myeloma can also cause hypercalcemia. So for those who know the crab symptoms of myeloma, the C stands for high calcium. The high calcium level can affect the kidneys. Dehydration can affect the kidneys because we have all that extra protein. If you lose too much fluid, the blood kind of gets a little sticky. It's kind of like driving your car for 200,000 miles and never changing the oil on a hot day. If you take too many drugs like NSAIDs, so too much Motrin, ibuprofen, or naproxenolive in the setting of myeloma, that can affect the kidneys. And unfortunately, a lot of patients with myeloma will have pain. So we really try to tell them to avoid drugs like NSAIDs. Are there associated risk factors for developing kidney disease, like having a particular type of myeloma? So it's really interesting. This is something we don't know a ton about because we often associate kidney disease with high light chain burden. But we have patients with sky-high light chains with normal kidneys and people with relatively low light chain numbers with really abnormal kidneys and everywhere in between. So there's really no great predictor. There is, however, a bit of a predilection for how the myeloma would affect the kidney based on the type. So in general, there are two types of myeloma, kappa and lambda. Lambda myeloma tends to cause things like amyloid more than kappa, and kappa tends to cause another disorder called light chain deposition disease more than lambda. So it's not so much that we can pick who is going to have the kidney problems and not, but you may have different risks of certain types of kidney problems with one type of myeloma or another.
HealthTree • October 20, 2021