Abstract: Castleman disease and POEMS syndrome are both rare diseases, and there is a close relationship between each other. A#60hough these two diseases have been investigated for decades, a comprehensive understanding of renal manifestations is still lacking. We reported a 44-year-old man who suffered from refractory ascites initially, and then developed renal insufficiency and lower limb edema. Physical examination at admission indicated mu#60iple hemangioma in the zone of neck and chest. There was a significant elevation in inflammatory indices and serum vascular endothelial growth factor, while the monoclonal protein was negative. The lymph node biopsy showed Castleman disease; and the skin biopsy showed glomeruloid hemangioma. Renal biopsy demonstrated endotheliopathy and tubular-interstitial injury. He was diagnosed with Castleman disease; and after the treatment with high dose glucocorticoid and immunosuppressants, the disease had been relieved rapidly and the renal function returned normal.