[Relation between certain parameters of renal function and prognosis in multiple myeloma]. / Povezanost nekih parametara renalne funkcije sa prognozom multipnog mijeloma.

BACKGROUND: Renal involvement is one of the most common manifestations of MM, with different pathogenetic mechanisms, like overproduction of monoclonal light chains and hypercalcemia, those are commonest precipitating factors for renal failure which occurs in nearly 25% of myeloma patients. Some renal pathology is noted in over half. METHODS: We studied retrospectively 16 patients with MM treated at Nephrology and Haemathology Clinic in Sarajevo, in the period from 1996-1999 y (10 females and 6 males). All fulfilled criteria for MM diagnosis: 1. Bone marrow involvement by greater than 20% plasma cells 2. Monoclonal paraprotein in the serum and/or urine 3. Lytic bone lesions. RESULTS: Appearance of high creatinine plasma level, red and white blood cells in urine, and proteinuria are the signs of renal function reduction. Renal failure was noted in 10/16, erythbruria 6/16, pyuria, 7/16 hyperuricemia in 8/16 and 3/16 (19%) were died during hemodialysis programme, and Bence-Jones protein was noted in urine with 7/16 (43%). Severe renal failure with 5/16 was noted and beside high plasma creatinine we found high plasma calcium and Bence Jones in urine. CONCLUSION: High plasma levels of creatinine and calcium and Bence-Jones in urine, are poor prognostic signs of MM.

[Anticardiolipin antibodies--detection and diagnostic value]. / Antikardiolipinska antitijela--dokazivanje i dijagnosticka vaznost.

Anticardiolipin antibodies belong to a family of antibodies to phospholid and are important in pathogenesis of some diseases. Statistically significant high titer of circulating anticardiolipin antibodies were found in SLE patients, thromboembolic events, thrombocytopenia and recurrent fetal loss. We tested 53 sera of SLE patients to anticardiolipin antibodies by own modification of ELISA. Only two sera were positive, one of them was associated with recurrent fetal loss and disease. The incidence of anticardiolipin antibodies in we have found no correlation with the activity of to those reported in other studies. Our tested sera (4%) was much lower in comparison.

[Clinical and histologic findings in patients with renal amyloidosis]. / Klinicki i histoloski nalazi u pacijenata sa renalnom amiloidozom.

Renal amyloidosis is a rare disease when compared to other kidney diseases. During the period of last fifteen years, at the Institute of Nephrology and Immunology in Sarajevo renal amyloidosis was diagnosed with 15 patients. The disease occurred more often with men than with women. Only during 1988, renal amyloidosis was revealed and followed up with five patients. The most common clinical manifestations of renal amyloidosis are nephrotic syndrome and chronic renal failure, with respective laboratory findings. Using immunofluorescent analysis of the kidney biopsy material, we discovered deposits of immunoglobulins of different intensity and deposits of lambda and kappa light chains of immunoglobulins. The intensity of lambda light chains is greater than that of kappa chains. The analysis of light microscopy showed nodular mesangial deposits and deposits along GBM without proliferation. The diagnosis of amyloidosis was confirmed by staining of amyloid. Application of therapy for amyloidosis was without any effect. Although renal amyloidosis is a rare disease, we want to point out disease as being an etiologic factor in nephrotic syndrome.

[Echocardiographic changes in patients with chronic renal insufficiency on hemodialysis]. / Ehokardiografske promjene kod pacijenata sa hronicnom bubreznom insuficijencijom na hemodijalizi.

Cardiovascular diseases cause death in 40% patients on the chronic haemodialysis program. Our aim was to assess the heart changes in these patients by echocardiography. We have tested 40 patients, but 34 of them accomplished criteria for this study. There were 19 (55.88%) females and 15 (44.12%) males. The average age was 44 years and average duration of haemodialysis treatment was 4.72 years. The research was made with ultrasound device TOSHIBA SSH 65 A SONOLAYER and transducers 3.5 and 2.75 MHz. Twenty patients (58.82%) have had pathological echocardiogram. Ten patients (29.42%) have had conditionally normal echocardiogram while four patients (11.76%) have had completely normal echocardiogram. In patients with pathological echocardiogram, some of the left ventricle hypertrophy forms dominated. Echocardiography is a useful method in morphologic and functional cardiac assessment at the last stage renal disease patients on the chronic haemodialysis program. Using the aforementioned method we are able to select the patients who need intensive cardiac care.