Abstract
RENAL MANIFESTATIONS OF MULTIPLE MYELOMA IN SUDANESE PATIENTS

Multiple myeloma is a haematological malignancy that characterized by neoplastic proliferation of a single clone of plasma cells producing a monoclonal immunoglobulin. This clone of plasma cells proliferates in the bone marrow and often results in extensive skeletal destruction with osteolytic lesions, osteopenia, and/or pathologic fractures. Most patients with MM present with signs or symptoms related to the infiltration of plasma cells into the bone or other organs or to kidney damage from excess light chains. The aim of this study is to study the frequency and pattern of renal diseases among Sudanese patients with multiple myeloma attending RICK .49 patients diagnosed as multiple myeloma were selected; data was collected using combined interview questionnaires and observation check list including the demographic and clinical data. Total protein, serum albumin, serum protein electrophoresis, blood urea, serum creatinine, and serum uric acid, serum electrolytes, (Na and K), serum Ca and serum Phosphorus were done. Urine analysis, abdominal ultrasound, bone marrow biopsy and renal biopsy were performed. Data was analyzed using SPSS. Ethical consents were obtained from all patients included in the study. Most of the patients included in the study were older than 40 years (83.68%) and the disease is rare below the age of 40 (16.33%) the mean age at presentation was 57 years old. Clinical presentation of MM patients showed bone pain and anaemia (75.5%, 67.3% respectively). Evidence of renal impairment is found in 40.8%, symptoms of hypercalcemia and infections are present in 24.5%, 16.3 respectively. 51% of patients have others manifestations. Patients with evidence of renal disease 40.8%, chronic Kidney disease (CKD) were 34.7%, while 2% presented with acute kidney injury (AKI). This study concluded that chronic renal disease is the main presenting pattern of renal diseases among patients with multiple myeloma. Renal impairment is more among patients with monoclonal and skeletal abnormalities are more frequent in those with renal disease. Precipitating factors seem to be similar to other studies.