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Light Chain Cast Nephropathy: Practical Considerations in the Management of Myeloma Kidney—What We Know and What the Future May Hold
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. Re...
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| Published in: | Current hematologic malignancy reports 2018-06, Vol.13 (3), p.220-226 |
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| Language: | English |
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| container_end_page | 226 |
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| container_title | Current hematologic malignancy reports |
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| creator | Manohar, Sandhya Nasr, Samih H. Leung, Nelson |
| description | 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. |
| doi_str_mv | 10.1007/s11899-018-0451-0 |
| format | article |
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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.</description><identifier>ISSN: 1558-8211</identifier><identifier>EISSN: 1558-822X</identifier><identifier>DOI: 10.1007/s11899-018-0451-0</identifier><identifier>PMID: 29725932</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Geriatrics/Gerontology ; Glomerulonephritis, Membranous - blood ; Glomerulonephritis, Membranous - etiology ; Glomerulonephritis, Membranous - therapy ; Glomerulonephritis, Membranous - urine ; Hematology ; Humans ; Immunoglobulin Light Chains - blood ; Immunoglobulin Light Chains - urine ; Medicine ; Medicine & Public Health ; Multiple Myeloma (P Kapoor ; Multiple Myeloma - blood ; Multiple Myeloma - complications ; Multiple Myeloma - therapy ; Multiple Myeloma - urine ; Oncology ; Section Editor ; Topical Collection on Multiple Myeloma ; Uromodulin - blood ; Uromodulin - urine</subject><ispartof>Current hematologic malignancy reports, 2018-06, Vol.13 (3), p.220-226</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2018</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c344t-7f1ef13b599b0d3c1d1bcbfacd851a90ad3b2f2102d520195dccd766437fa95b3</citedby><cites>FETCH-LOGICAL-c344t-7f1ef13b599b0d3c1d1bcbfacd851a90ad3b2f2102d520195dccd766437fa95b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29725932$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Manohar, Sandhya</creatorcontrib><creatorcontrib>Nasr, Samih H.</creatorcontrib><creatorcontrib>Leung, Nelson</creatorcontrib><title>Light Chain Cast Nephropathy: Practical Considerations in the Management of Myeloma Kidney—What We Know and What the Future May Hold</title><title>Current hematologic malignancy reports</title><addtitle>Curr Hematol Malig Rep</addtitle><addtitle>Curr Hematol Malig Rep</addtitle><description>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.</description><subject>Geriatrics/Gerontology</subject><subject>Glomerulonephritis, Membranous - blood</subject><subject>Glomerulonephritis, Membranous - etiology</subject><subject>Glomerulonephritis, Membranous - therapy</subject><subject>Glomerulonephritis, Membranous - urine</subject><subject>Hematology</subject><subject>Humans</subject><subject>Immunoglobulin Light Chains - blood</subject><subject>Immunoglobulin Light Chains - urine</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Multiple Myeloma (P Kapoor</subject><subject>Multiple Myeloma - blood</subject><subject>Multiple Myeloma - complications</subject><subject>Multiple Myeloma - therapy</subject><subject>Multiple Myeloma - urine</subject><subject>Oncology</subject><subject>Section Editor</subject><subject>Topical Collection on Multiple Myeloma</subject><subject>Uromodulin - blood</subject><subject>Uromodulin - urine</subject><issn>1558-8211</issn><issn>1558-822X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp9kM1u1TAQRiMEoqXwAGyQl2wCHv80MTsUtRT1FliAys6a2M5NqsS-2I5Qdl31CXhCnoRcbumS1YzG5_skn6J4CfQNUFq9TQC1UiWFuqRCQkkfFccgZV3WjH1__LADHBXPUrqhVAig_GlxxFTFpOLsuLjbDNs-k6bHwZMGUyaf3K6PYYe5X96RLxFNHgyOpAk-DdZFzMO6kZXOvSNX6HHrJuczCR25WtwYJiSXg_Vu-X3767rHTK4dufThJ0Fvyd_DPng-5znu8wu5CKN9XjzpcEzuxf08Kb6dn31tLsrN5w8fm_eb0nAhcll14DrgrVSqpZYbsNCatkNjawmoKFreso4BZVYyCkpaY2x1eip41aGSLT8pXh96dzH8mF3KehqSceOI3oU5aUa5ZEIIWq8oHFATQ0rRdXoXhwnjooHqvX590K9X_XqvX9M18-q-fm4nZx8S_3yvADsAaX3yWxf1TZijX7_8n9Y_br2SDw</recordid><startdate>20180601</startdate><enddate>20180601</enddate><creator>Manohar, Sandhya</creator><creator>Nasr, Samih H.</creator><creator>Leung, Nelson</creator><general>Springer US</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20180601</creationdate><title>Light Chain Cast Nephropathy: Practical Considerations in the Management of Myeloma Kidney—What We Know and What the Future May Hold</title><author>Manohar, Sandhya ; Nasr, Samih H. ; Leung, Nelson</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c344t-7f1ef13b599b0d3c1d1bcbfacd851a90ad3b2f2102d520195dccd766437fa95b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Geriatrics/Gerontology</topic><topic>Glomerulonephritis, Membranous - blood</topic><topic>Glomerulonephritis, Membranous - etiology</topic><topic>Glomerulonephritis, Membranous - therapy</topic><topic>Glomerulonephritis, Membranous - urine</topic><topic>Hematology</topic><topic>Humans</topic><topic>Immunoglobulin Light Chains - blood</topic><topic>Immunoglobulin Light Chains - urine</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Multiple Myeloma (P Kapoor</topic><topic>Multiple Myeloma - blood</topic><topic>Multiple Myeloma - complications</topic><topic>Multiple Myeloma - therapy</topic><topic>Multiple Myeloma - urine</topic><topic>Oncology</topic><topic>Section Editor</topic><topic>Topical Collection on Multiple Myeloma</topic><topic>Uromodulin - blood</topic><topic>Uromodulin - urine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Manohar, Sandhya</creatorcontrib><creatorcontrib>Nasr, Samih H.</creatorcontrib><creatorcontrib>Leung, Nelson</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Current hematologic malignancy reports</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Manohar, Sandhya</au><au>Nasr, Samih H.</au><au>Leung, Nelson</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Light Chain Cast Nephropathy: Practical Considerations in the Management of Myeloma Kidney—What We Know and What the Future May Hold</atitle><jtitle>Current hematologic malignancy reports</jtitle><stitle>Curr Hematol Malig Rep</stitle><addtitle>Curr Hematol Malig Rep</addtitle><date>2018-06-01</date><risdate>2018</risdate><volume>13</volume><issue>3</issue><spage>220</spage><epage>226</epage><pages>220-226</pages><issn>1558-8211</issn><eissn>1558-822X</eissn><abstract>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.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>29725932</pmid><doi>10.1007/s11899-018-0451-0</doi><tpages>7</tpages></addata></record> |
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| source | Springer Nature |
| subjects | Geriatrics/Gerontology Glomerulonephritis, Membranous - blood Glomerulonephritis, Membranous - etiology Glomerulonephritis, Membranous - therapy Glomerulonephritis, Membranous - urine Hematology Humans Immunoglobulin Light Chains - blood Immunoglobulin Light Chains - urine Medicine Medicine & Public Health Multiple Myeloma (P Kapoor Multiple Myeloma - blood Multiple Myeloma - complications Multiple Myeloma - therapy Multiple Myeloma - urine Oncology Section Editor Topical Collection on Multiple Myeloma Uromodulin - blood Uromodulin - urine |
| title | Light Chain Cast Nephropathy: Practical Considerations in the Management of Myeloma Kidney—What We Know and What the Future May Hold |
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