The pathogenesis and diagnosis of acute kidney injury in multiple myeloma

Colin A. Hutchison, Vecihi Batuman, Judith Behrens, Frank Bridoux, Christophe Sirac, Angela Dispenzieri, Guillermo A. Herrera, Helen Lachmann, Paul W. Sanders

Research output: Contribution to journalArticle

138 Citations (Scopus)

Abstract

Renal failure remains a principal cause of morbidity for patients with multiple myeloma. Once reversible factors such as hypercalcemia have been corrected, the most common cause of severe renal failure in these patients is a tubulointerstitial pathology that results from the very high circulating concentrations of monoclonal immunoglobulin free light chains. These endogenous proteins can result in isolated proximal tubule cell cytotoxicity, tubulointerstitial nephritis and cast nephropathy (myeloma kidney). Less frequently, high levels of free light chains can lead to immunoglobulin light chain amyloidosis and light chain deposition disease, although these conditions are usually associated with insidious progression of renal failure rather than acute kidney injury. Unless there is rapid intervention, progressive and irreversible damage occurs, particularly interstitial fibrosis and tubular atrophy. Despite advances in our understanding of the pathogenesis of these processes there has been a gap in translating these achievements into improved patient outcomes. The International Kidney and Monoclonal Gammopathy Research Group was formed to address this need. In this Review, we discuss the mechanisms of disease and diagnostic approaches to patients with acute kidney injury complicating multiple myeloma.

Original languageEnglish (US)
Pages (from-to)43-51
Number of pages9
JournalNature Reviews Nephrology
Volume8
Issue number1
DOIs
StatePublished - Jan 2012

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Multiple Myeloma
Acute Kidney Injury
Renal Insufficiency
Immunoglobulin Light Chains
Kidney
Light
Interstitial Nephritis
Paraproteinemias
Hypercalcemia
Amyloidosis
Atrophy
Fibrosis
Pathology
Morbidity
Research
Proteins

ASJC Scopus subject areas

  • Nephrology

Cite this

Hutchison, C. A., Batuman, V., Behrens, J., Bridoux, F., Sirac, C., Dispenzieri, A., ... Sanders, P. W. (2012). The pathogenesis and diagnosis of acute kidney injury in multiple myeloma. Nature Reviews Nephrology, 8(1), 43-51. https://doi.org/10.1038/nrneph.2011.168

The pathogenesis and diagnosis of acute kidney injury in multiple myeloma. / Hutchison, Colin A.; Batuman, Vecihi; Behrens, Judith; Bridoux, Frank; Sirac, Christophe; Dispenzieri, Angela; Herrera, Guillermo A.; Lachmann, Helen; Sanders, Paul W.

In: Nature Reviews Nephrology, Vol. 8, No. 1, 01.2012, p. 43-51.

Research output: Contribution to journalArticle

Hutchison, CA, Batuman, V, Behrens, J, Bridoux, F, Sirac, C, Dispenzieri, A, Herrera, GA, Lachmann, H & Sanders, PW 2012, 'The pathogenesis and diagnosis of acute kidney injury in multiple myeloma', Nature Reviews Nephrology, vol. 8, no. 1, pp. 43-51. https://doi.org/10.1038/nrneph.2011.168
Hutchison, Colin A. ; Batuman, Vecihi ; Behrens, Judith ; Bridoux, Frank ; Sirac, Christophe ; Dispenzieri, Angela ; Herrera, Guillermo A. ; Lachmann, Helen ; Sanders, Paul W. / The pathogenesis and diagnosis of acute kidney injury in multiple myeloma. In: Nature Reviews Nephrology. 2012 ; Vol. 8, No. 1. pp. 43-51.
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