{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T09:10:14Z","timestamp":1788858614899,"version":"build-2803163510"},"reference-count":0,"publisher":"MediaMedica - MMA Limited Liability Company","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CRGP"],"published-print":{"date-parts":[[2026,8,24]]},"abstract":"<jats:p>A complex clinical case of stage III multiple myeloma (MM) in a 60-year-old patient with multiple organ lesions is presented, illustrating diagnostic and therapeutic challenges in modern hematology. The emphasis is on the exceptional clinical polymorphism of the disease, which leads to prolonged &amp;quot;diagnostic wandering&amp;quot;: the patient consistently exhibited bone (imitating osteochondrosis), renal (terminal chronic renal failure \u2013 CRF \u2013 requiring hemodialysis) and cardiac (refractory hypertension, heart failure) syndromes.The diagnosis was verified based on a complex of laboratory (IgG paraproteinemia, Bence Jones protein excretion, hyperproteinemia, a sharp increase in \u03b22-microglobulin &amp;gt;16,000 ng\/L) and instrumental methods (CT, MRI), those who have identified a widespread osteodestructive process. A special feature of the case is a combination of life-threatening complications: myeloma nephropathy with stage V CRF on programmed hemodialysis, refractory arterial hypertension, chronic heart failure with reduced ejection fraction and secondary anemia. The article analyzes in detail the therapeutic dilemmas caused by the need to balance between aggressive antitumor treatment (VD scheme \u2013 bortezomib + dexamethasone) and correction of severe concomitant pathology that limits the possibilities of therapy. Interdisciplinary recommendations of a hematologist, cardiologist, and nephrologist are presented, and the choice of medications is justified, taking into account multiple organ failure and the high risk of drug interactions.\r\n\r\nKeywords: multiple myeloma, end-stage renal failure, hemodialysis, resistant arterial hypertension, chronic heart failure.<\/jats:p>","DOI":"10.47407\/kr2026.7.7.00886","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T08:40:28Z","timestamp":1788856828000},"page":"58-61","source":"Crossref","is-referenced-by-count":0,"title":["Multiple myeloma with paraproteinemia and terminal chronic renal failure on the background of hemodialysis: therapy for concomitant refractory hypertension and heart failure (clinical case)"],"prefix":"10.47407","volume":"7","author":[{"name":"Georgievsky Order of the Red Banner Medical Institute, Vernadsky Crimean Federal University, Simferopol, Russia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yana V","family":"Sharnina","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Georgievsky Order of the Red Banner Medical Institute, Vernadsky Crimean Federal University, Simferopol, Russia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vitaliy B","family":"Kaliberdenko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"1472 Naval Clinical Hospital, Simferopol, Russia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalya N","family":"Yaroshenko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Consultative and Diagnostic Service Center for Deported Peoples, Simferopol, Russia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia Ju","family":"Kulagina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Consultative and Diagnostic Service Center for Deported Peoples, Simferopol, Russia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gulfire R","family":"Osmanova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Georgievsky Order of the Red Banner Medical Institute, Vernadsky Crimean Federal University, Simferopol, Russia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riana O","family":"Islyamova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"27046","published-online":{"date-parts":[[2026,8,24]]},"container-title":["Clinical review for general practice"],"original-title":["\u041c\u043d\u043e\u0436\u0435\u0441\u0442\u0432\u0435\u043d\u043d\u0430\u044f \u043c\u0438\u0435\u043b\u043e\u043c\u0430 \u0441 \u043f\u0430\u0440\u0430\u043f\u0440\u043e\u0442\u0435\u0438\u043d\u0435\u043c\u0438\u0435\u0439 \u0438 \u0442\u0435\u0440\u043c\u0438\u043d\u0430\u043b\u044c\u043d\u043e\u0439 \u0445\u0440\u043e\u043d\u0438\u0447\u0435\u0441\u043a\u043e\u0439 \u043f\u043e\u0447\u0435\u0447\u043d\u043e\u0439 \u043d\u0435\u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u043e\u0441\u0442\u044c\u044e \u043d\u0430 \u0444\u043e\u043d\u0435 \u0433\u0435\u043c\u043e\u0434\u0438\u0430\u043b\u0438\u0437\u0430: \u0442\u0435\u0440\u0430\u043f\u0438\u044f \u043f\u0440\u0438 \u0441\u043e\u043f\u0443\u0442\u0441\u0442\u0432\u0443\u044e\u0449\u0435\u0439 \u0440\u0435\u0444\u0440\u0430\u043a\u0442\u0435\u0440\u043d\u043e\u0439 \u0433\u0438\u043f\u0435\u0440\u0442\u0435\u043d\u0437\u0438\u0438 \u0438 \u0441\u0435\u0440\u0434\u0435\u0447\u043d\u043e\u0439 \u043d\u0435\u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u043e\u0441\u0442\u0438 (\u043a\u043b\u0438\u043d\u0438\u0447\u0435\u0441\u043a\u0438\u0439 \u0441\u043b\u0443\u0447\u0430\u0439)"],"deposited":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T08:40:34Z","timestamp":1788856834000},"score":1,"resource":{"primary":{"URL":"https:\/\/klin-razbor.ru\/en\/archive\/2026\/vol-7-7-2026\/multiple-myeloma-with-paraproteinemia-and-terminal-chronic-renal-failure-on-the-background-of-hemodi_7829\/?element"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,24]]},"references-count":0,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,8,24]]},"published-print":{"date-parts":[[2026,8,24]]}},"URL":"https:\/\/doi.org\/10.47407\/kr2026.7.7.00886","relation":{},"ISSN":["2713-2552","2782-5671"],"issn-type":[{"value":"2713-2552","type":"print"},{"value":"2782-5671","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,24]]}}}