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December 5, 2017

High-Cutoff Hemodialysis in Myeloma Cast Nephropathy

Author Affiliations
  • 1Division of of Kidney Diseases and Hypertension, Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Great Neck, New York
  • 2Division of Hematology and Medical Oncology, Multiple Myeloma Center, Weill Cornell Medical Center, New York Presbyterian Hospital, New York City, New York
JAMA. 2017;318(21):2085-2086. doi:10.1001/jama.2017.18710

Multiple myeloma accounts for approximately 13% of all hematologic malignancies and is characterized by the neoplastic proliferation of clonal plasma cells that usually produce unique immunoglobulins (either intact or immunoglobulin light chains).1 Light chains can lead to tubular, interstitial, and glomerular damage in the kidney.2,3 Among patients with multiple myeloma, reduced kidney function has been associated with poor prognosis and shorter survival.3 The most common form of kidney disease reported on biopsy among patients with multiple myeloma is cast nephropathy (CN),4 which is a tubular interstitial disorder. The type of acute kidney injury (AKI) seen with CN can be mild but in some cases it may be severe and require dialysis.3