Novel approaches for reducing free light chains in patients with myeloma kidney

Colin A. Hutchison, Joan Bladé, Paul Cockwell, Mark Cook, Mark Drayson, Jean Paul Fermand, Efstathios Kastritis, Robert Kyle, Nelson Leung, Sonia Pasquali, Christopher Winearls

Research output: Contribution to journalArticlepeer-review

Abstract

Myeloma kidney is a tubulointerstitial pathology that accounts for approximately 80-90% of severe acute kidney injury in patients with multiple myeloma. Unless there is rapid intervention, progressive irreversible damage from interstitial fibrosis and tubular atrophy occurs. Work over the past decade has demonstrated that an early sustained reduction in serum concentrations of pathogenic monoclonal free light chains (FLCs) leads to improved renal recovery rates. In turn, an early improvement in renal function is associated with improved patient survival. An early reduction in FLC levels should therefore become standard of care, although the optimum mechanisms to achieve this depletion of FLCs remain to be determined. To provide a coordinated, cross-disciplinary approach to research in this disease, the International Kidney and Monoclonal Gammopathy Research Group was formed. In this Review, we address the current state of knowledge in the management of myeloma kidney.

Original languageEnglish
Pages (from-to)234-243
Number of pages10
JournalNature Reviews Nephrology
Volume8
Issue number4
DOIs
Publication statusPublished - Apr 2012

ASJC Scopus subject areas

  • Nephrology

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