FEATURES OF RENAL BLOOD FLOW IN PATIENTS WITH MULTIPLE MYELOMA AT DIFFERENT STAGES OF TUMOR PROGRESSION

Abstract

The features of renal hemodynamics in 90 patients with multiple myeloma (MM) at different stages of tumor progression have been studied. The signs of renal hemodynamics disorder by ultrasound Dopplermetry data are already revealed at the first stages of MM. In the I and IIA stages there were diagnosed the following changes: the increase in average blood flow velocity (Vave) at the level of the interlobular arteries (20%); the reduction of peak systolic velocity (Vmax) at the level of arteries arc (11.4%); the drop of Vmax (24.5%), of Vave (11%), of diastolic velocity (Vmin) by 26% on interlobular arteries; the decrease of Vmin (26%) on segmental and main renal arteries. There was also revealed an increase in the indices of vascular resistance index (IR by 11%, IP by 13%) and main renal arteries (IR by 12%, IP by 16%). Under disease progression in IIIA stage there was: the growth of Vmax (21.5%), Vave (24.9%), Vmin (42.7%) on interlobular arteries; the decrease of Vave (24.8%), Vmin (51.5%) on interlobular renal arteries. The decrease of IR on interlobular arteries (9%) and its increase at the level of segmental and main renal arteries (11%) were diagnosed. The biggest changes in the blood flow by Dopplermetry data were diagnosed in MM patients at chronic renal disease (IІ and IIIB stages): the reduction of speed indicators on interlobular arteries - Vmax (26%), Vave (42%), Vmin (44%); on arc arteries - Vmax (29%), Vave (21%), Vmin (38%); on interlobar arteries - Vmax (30%), Vave (39%), Vmin (46%); on segmental arteries - Vmax (17%), Vave (22%), Vmin (42%); on the main renal artery - Vmax (11%), Vmin (33%). An increase in the indices of vascular resistance was revealed: IR on interlobular arteries (11%), the arc arteries (12%), interlobular arteries (11%), segmental arteries (13%), the main renal arteries (11%); IP on interlobular arteries (13%), the arc arteries (12%), interlobular arteries (13%), segmental arteries (12%), the main renal arteries (12%). These parameters correspond to Doppler criteria of chronic renal insufficiency of compensated stage.