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

Sandhya Manohar, Samih H. Nasr, Nelson Leung

Research output: Contribution to journalArticle

4 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalCurrent Hematologic Malignancy Reports
StateAccepted/In press - May 3 2018



  • Acute kidney injury
  • Cast nephropathy
  • Light chains
  • Multiple myeloma
  • Myeloma kidney
  • Plasma cell dyscrasia

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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