Kidney Failure In Multiple Myeloma Patients - Part 4: Hemodialysis
Published: Aug 17, 2009 11:36 pm
Research shows that approximately 20 percent of multiple myeloma patients develop kidney failure. Kidney failure occurs as a consequence of elevated calcium levels in the blood or when proteins called light chains are produced in excess - overloading the kidneys with protein.
Normally, the kidneys remove wastes, extra fluids, and minerals from the blood. But when they stop functioning, harmful wastes build up and this can cause other complications such as high blood pressure. Generally, kidney failure can worsen for multiple myeloma patients with fluid depletion, hypercalcemia, infection, nephrotoxic drugs (chemicals that are harmful for the kidneys) and proteinuria (when patient’s urine is presented with excess proteins).
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When kidney failure is irreversible, patients undergo a procedure known as dialysis to help their bodies filter blood. Dialysis removes the extra fluid and waste from the blood, and it can prolong the overall survival for multiple myeloma patients.
In the procedure, blood flows by a few ounces each time through a dialyzer or artificial kidneys, and removes excess wastes and fluid. The dialyzer contains two fluid compartments, with blood flowing through one compartment, and a solution called dialysate flowing through the other in the opposite direction. While the patient's blood has a high concentration of solutes like urea, potassium, and proteins; the dialysate has a low concentration of solutes. The dialysate therefore acts like a sponge to soak up the excess solutes from the blood. As the two liquids flow in opposite directions, a semi-permeable membrane allows the excess water and solutes to diffuse out of the blood and into the dialysate.
Hemodialysis requires a strict schedule. The total treatment follows a regular schedule, usually three times per week, and takes three to five hours for each session. Treatment can be done at a center or at home. Some patients even have dialysis done overnight.
Before hemodialysis treatment begins, patients may want to prepare a designated site of access on their body for the blood to be removed from and returned to. This is known as a vascular access and it allows for a more efficient procedure. More information about vascular access for hemodialysis can be found here.
There are some side effects from hemodialysis, but most of them are due to the change in salt and fluid amounts between dialysis treatments. Side effects include low blood pressure, lightheadedness, shortness of breath, abdominal cramps, muscle cramps, nausea, or vomiting. They can be minimized by diet and fluid intake.
For more information about hemodialysis, go to the National Institute of Diabetes and Digestive and Kidney Diseases Web site and the UpToDate patient's guide on hemodialysis. Also, visit the Beacon articles in this series and related Beacon articles on kidney failure.
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My husband, age 59, was diagnosed with multiple myeloma in mid-December, 2009, and since then he has kidney failure and now is on dialysis. He was also receiving chemotherapy for 1 week, and had to have chemo suspended because he developed a fever of 103 and was taken to our local hospital. Then, he developed on-going nosebleeds and near an area by his catheter, which could not be stopped for a couple of hours. He has since been transferred to a larger medical center in Milwaukee, WI because the last time he had dialysis in our local hospital, an RN noticed his skin was very yellow. He was diagnosed as Stage 3 with the multiple myeloma. (He is a farmer for the last 38 years, dealing with various chemicals and fertilizer for our crops).
I do not know if he is or will be considered a candidate for a stem cell transplant, he is so sick. What is his prognosis for survival and does anyone have any idea how long he might survive? It is a great worry to me and my children.
I would appreciate an in depth response to my husband's diagnosis of the multiple myeloma with kidney failure.
Thankyou so much.
Beverly, my father , age 79, was diagnosed with Myeloma in July 2008.
Since then he went through 3 different chemo Melphalano, Velcade and now Zometa plus doing Radiotherapy in his vert. column . We never know how long a pacient will survive. They react different to the medication. Some of them have more side effects and other pacients dont feel side effects. My father also had complications like Herpes because of the low immunity. Myeloma releases lots of Calcium from the bones in the blood and this makes the kidney work too hard to filter. My father is a phisician for 52 years now and had as a hobby to make wine in home . He also always liked to plant the grape vines and was exposed to chemicals and fertilizers in a daily basis because he never missed a day without walking between the grapevines that he palnted.
Your husband is very young and he may respond well to the medication. Keep your hope. There is many alternative treatments . Every day they find something new. Only this month of January we find a Doctor that was able to keep him without pain and also eating better. I dont know a lot. Just could not go away without giving you a word after reading your post. Try to find the IMF, International Fundation of Myeloma. You can read the pacients histories and exchange ideas. Also you need to eat and sleep well to be able to help him .
Hope I helped
Grace