Thirty-one were cases of light chain cast nephropathy (also referred to as "myeloma kidney") and they were not further analyzed, as the main purpose of the article is to address proximal nephron-centered lesions.
Comparison of the percentage of light chain cast nephropathy cases (33% of all cases associated with plasma cell dyscrasia) with proximal tubular-centered cases (roughly 46% of all cases with underlying plasma cell dyscrasias) emphasizes that the total number of proximal tubulopathies indeed represents a very significant portion of all lesions observed.
Cast nephropathy with acute renal failure treated with high cut-off haemodialysis in a patient with multiple myeloma.
High cut-off haemodialysis and bortezomib-based therapy to rescue kidneys in myeloma-dependent cast nephropathy.
As a result, the peculiar histologic lesion of the myeloma cast nephropathy consists of a chronic tubulointerstitial nephropathy with marked tubular atrophy, laminated intratubular casts, and extensive interstitial fibrosis.
The measurement of serum concentration of the clonal FLCs and that of urine level of albumin may be considered the landmarks for screening algorithms in patients with cast nephropathy .
The most common cause of renal insufficiency in patients with multiple myeloma, occurring in approximately 30% of patients, is cast nephropathy
If cast nephropathy
or acute proximal tubular damage is present, acute renal failure is a common manifestation.
Tubular casts morphologically similar to those seen in myeloma light chain cast nephropathy
have been reported in association with sirolimus-induced acute renal failure.