Multiple myeloma and renal involvement

Multiple myeloma represents a malignant plasma cell disease responsible for approximately 10-15% of all malignant hematological disorders. Renal involvement is a common complication of multiple myeloma and up to 10% of patients with multiple myeloma develop a dialysis-dependent acute renal failure. At the time of diagnosis 20-50% of myeloma patients already have renal impairment. Light chain cast nephropathy is the most common form of renal involvement in multiple myeloma leading to acute renal failure. Free light chains play a key role in the pathogenesis of light chain cast nephropathy. The amount of free light chains in the blood is directly related to the risk of developing light chain cast nephropathy. The renal response and thus the recovery of renal function is directly associated with the rate and extent of light chain reduction in the blood. Various extracorporeal techniques for rapid elimination of free light chains have been critically examined in recent years.