Abstract
A 59-year-old female patient underwent total gastrectomy for early gastric cancer. On the 11th postoperative day, renal function rapidly declined and the patient demonstrated oliuria and hyperkalemia. The serum creatinine level was elevated to 8mg/dl, then hemodialysis was initiated. Urinary Bence-Jones protein and monoclonal IgA were detected by immunoelectrophoreis. On the 88th postoperative day, renal biopsy was performed, and the specimen showed eosinophilic casts in the renal tubules. Thus, a diagnosis of multiple myeloma and associated acute renal failure was made. Urinary volume gradually increased after an oliguric phase lasting for one month. However, her general condition deteriorated because of infection and the patient died.
In this case, the preoperative urine and blood examination did not show any abnormalities suggestive of multiple myeloma. However, the patient developed acute renal failure postoertively. We conclude that postoperative pyrexia and dehydration contributed to the rise of urinary Bence-Jones protein, which led to the development of acute renal failure.
