Kidney failure and damage are common complications of multiple myeloma, a type of blood cancer. But there are several treatment options to help counteract kidney failure.
Multiple myeloma is a type of cancer that forms in the plasma cells, which are white blood cells found in the bone marrow. They’re a key part of the immune system. They make antibodies that fight infection.
Cancerous plasma cells grow quickly and take over the bone marrow by blocking healthy cells from doing their job. They make large amounts of abnormal proteins that travel throughout the body and can be detected in the bloodstream. The cancerous cells can also grow into tumors called plasmacytomas.
When more than 10 percent of the cells in the bone marrow are cancerous, and other organs are involved, it’s known as multiple myeloma.
The growth of multiple myeloma cells interferes with the production of normal plasma cells. This can cause several health complications. The areas most affected are the kidneys, bones, and blood.
Kidney failure in multiple myeloma is a complicated process that involves various mechanisms. The primary cause of this kidney failure is abnormal proteins called monoclonal light chains.
Multiple myeloma cells make monoclonal light chains, which travel to the kidneys and deposit themselves there.
Monoclonal light chains can have a toxic effect on the kidneys’ tubules and glomeruli. Tubules are small tubes that help filter waste. Glomeruli are capillaries, or small blood vessels, located on the ends of tubules.
Monoclonal light chains can obstruct the tubules and alter the kidneys’ filtering properties.
In addition, kidney damage may occur as a result of crystals forming in the kidneys. Elevated calcium levels, which are a complication of multiple myeloma, can cause this crystal formation.
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Other causes of kidney damage include dehydration and medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs).
There are several ways that people with multiple myeloma can keep their kidneys healthy, especially when the condition is caught early:
- Treating and managing multiple myeloma is the preferred method for counteracting kidney failure. This typically involves targeted therapies, chemotherapy based around bortezomib (Velcade), or both.
- Anti-inflammatory drugs called glucocorticoids can reduce cell activity. These types of steroids are often given alongside targeted therapies.
- Medications called bisphosphonates can be taken to reduce bone damage and high blood calcium levels. They’re most commonly used to treat osteoporosis.
- People can get fluid therapy, either orally or intravenously, to rehydrate the body.
- Dialysis can take some of the strain off kidney function.
Did you know?
Kidney problems are a common side effect of chemotherapy. Multiple myeloma medications administered in chemotherapy can be adjusted so as not to further harm the kidneys.
There are other common complications of multiple myeloma aside from kidney-related ones.
Around 85 percent of people with multiple myeloma experience bone damage or loss, according to the Multiple Myeloma Research Foundation (MMRF). The most commonly affected bones are the spine, rib cage, and pelvis.
Cancerous cells in the bone marrow prevent normal cells from repairing lesions, which are soft spots that form in the bones. Decreased bone density can lead to fractures and spinal cord compression.
The production of cancerous plasma cells interferes with the production of normal red and white blood cells.
Anemia occurs when a person’s red blood cell count is low. It can cause fatigue, shortness of breath, and dizziness. According to the MMRF, more than 60 percent of people with multiple myeloma have anemia at the time of their cancer diagnosis. Even more will develop anemia later.
Weak immune system
White blood cells fight infection in the body. They recognize and attack harmful germs that cause disease.
Large numbers of cancerous plasma cells in the bone marrow result in low numbers of normal white blood cells. This leaves the body vulnerable to infection.
The abnormal antibodies produced by cancerous cells don’t help to fight infection. They can also overtake healthy antibodies, resulting in a weakened immune system.
Bone loss from multiple myeloma causes an excess of calcium to be released into the bloodstream, a condition known as hypercalcemia. People with bone tumors are at an increased risk of developing hypercalcemia.
Another cause of hypercalcemia is overactive parathyroid glands. These glands are located in the neck and control calcium levels throughout the body. Untreated cases of overactive parathyroid glands can lead to many different symptoms, such as coma (in rare cases) and cardiac arrest.
Kidney failure is a common effect of multiple myeloma, but kidney damage can be minimal when multiple myeloma is identified and treated in its early stages.
Treatment options are also available to help reverse kidney damage caused by multiple myeloma.