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Current Hematologic Malignancy Reports
Published in: Current Hematologic Malignancy Reports 3/2018

01-06-2018 | Multiple Myeloma (P Kapoor, Section Editor)

Light Chain Cast Nephropathy: Practical Considerations in the Management of Myeloma Kidney—What We Know and What the Future May Hold

Authors: Sandhya Manohar, Samih H. Nasr, Nelson Leung

Published in: Current Hematologic Malignancy Reports | Issue 3/2018

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Abstract

Purpose of review

To update and evaluate the current knowledge on pathogenesis and management of light chain cast nephropathy. Light chain cast nephropathy (LCCN) is the leading cause of acute renal failure in patients with multiple myeloma and is currently recognized as a myeloma defining event.

Recent findings

The immunoglobulin free light chain plays an integral role in the pathogenesis of LCCN. The level of free light chain (FLC) in the blood and urine is directly associated with the risk of developing LCCN. Recovery of renal function is related to the speed and degree of the serum FLC reduction. Recently, two randomized trials using high cutoff dialyzer for the removal of serum FLC produced different results in terms of renal recovery.

Summary

FLC plays a key role in the development and resolution of LCCN. Future therapies will aim to rapidly reduce its concentration or interrupt its interaction with Tamm-Horsfall protein.
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Metadata
Title
Light Chain Cast Nephropathy: Practical Considerations in the Management of Myeloma Kidney—What We Know and What the Future May Hold
Authors
Sandhya Manohar
Samih H. Nasr
Nelson Leung
Publication date
01-06-2018
Publisher
Springer US
Published in
Current Hematologic Malignancy Reports / Issue 3/2018
Print ISSN: 1558-8211
Electronic ISSN: 1558-822X
DOI
https://doi.org/10.1007/s11899-018-0451-0

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