ON THE PATHOGENESIS OF RENAL FAILURE ASSOCIATED WITH MULTIPLE MYELOMA. ELECTROPHORETIC AND CHEMICAL ANALYSIS OF PROTEIN IN URINE AND BLOOD SERUM 1

Abstract

The protein in the urine of a patient with multiple myeloma and progressive renal insufficiency was shown by solubility methods to be a Bence-Jones protein. The urine was also analyzed electrophoretically and chemically (analysis of 12 twenty-four hour specimens in 5 months). In both methods of analysis the Bence-Jones protein behaved like a globulin. Electrophoretically it moved like the B-globulin of normal blood plasma. The total plasma protein of the patient was normal, but there was a marked increase in the electrophoretic [beta] globulin fraction, which was excreted in the urine as Bence-Jones protein. During the period of observation the conc. of protein in the urine varied from 0.475 to 0.744 gs. %, and the proportion of Bence-Jones protein usually varied from 92-100% of the total. The results suggest that in multiple myeloma, as in other forms of Bright''s disease previously investigated, the development of that portion of renal insufficiency which is caused by precipitation of plasma protein within glomeruli and tubules of the kidney is detd. chiefly by the duration of high concs. in the urine of proteins having salting-out and electrophoretic properties of globulins.