title: Kidney disease and multiple myeloma.
abstract: Kidney injury is a common complication of multiple myeloma and other plasma cell dyscrasias, and it is associated with increased mortality. Multiple pathogenic mechanisms can contribute to kidney injury in the patient with myeloma, some of which are the result of nephrotoxic monoclonal Ig and some of which are independent of paraprotein deposition. The pathogenic mechanisms that underlie paraprotein-related kidney disease are increasingly well understood. A novel assay allowing the quantification of free light chains in the serum has aided the diagnosis of new onset disease and allowed for the earlier detection of relapse. Novel myeloma agents have shown considerable promise in reversing renal failure in some patients and improving outcomes. Stem cell transplantation remains a mainstay of management for younger patients with myeloma who are suitable candidates for intensive therapy, whereas the role of new drugs, plasma exchange, and kidney transplantation continues to evolve.
authors.affiliation: Nephrology Division and Transplantation Center, Massachusetts General Hospital, Boston, Massachusetts;, †Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, ‡Jerome Lipper Multiple Myeloma Center, Division of Hematologic Malignancy, Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Eliot C
authors.initials: EC
authors.lastname: Heher
authors.forename: Helmut G
authors.initials: HG
authors.lastname: Rennke
authors.forename: Jacob P
authors.initials: JP
authors.lastname: Laubach
authors.forename: Paul G
authors.initials: PG
authors.lastname: Richardson
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology / Q000628:therapy; D000818:Animals; D000970:Antineoplastic Agents / Q000627:therapeutic use; D006801:Humans; D007136:Immunoglobulins / Q000097:blood; D016030:Kidney Transplantation; D009101:Multiple Myeloma / Q000150:complications* / Q000175:diagnosis / Q000276:immunology / Q000628:therapy; D010951:Plasma Exchange; D033581:Stem Cell Transplantation; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D007136:Immunoglobulins