Renal impairment (RI) is a common complication of multiple myeloma (MM), whichis presented as chronic kidney disease (CKD) or acute kidney injury (AKI).The typical pathologicalfeature is cast nephropathy.Presently international system staging (ISS) is used in evaluating MM.Althoughthe classic Durie-Salmon staging system could be still used in clinical practice , it may miss out some patientswith renal impairment.For evaluations of RI in MM patients with CKD, it′s recommended to assess theestimated glomerular filtration rate (eGFR) by creatinine based formula CKD-epidemiology collaboration(EPI) or modification of diet in renal disease (MDRD) and to stage the renal injuries according to 2013Kidney Disease Improving Global Outcomes (KDIGO) CKD guidelines.For MM patients with AKI, KDIGOAKI guidelines is recommended for evaluation.Renal biopsy is not a routine procedure in all MM patients .It′s necessary for patients presenting with glomerular injuries such as albuminuria >1 g/24 h to eliminateimmunoglobulin a

作者：多发性骨髓瘤肾损伤诊治专家共识协作组

来源：中华内科杂志 2017 年 56卷 11期