title: Managing renal complications in multiple myeloma.
abstract: BACKGROUND
  About 20-40% of patients with multiple myeloma (MM) will present with some degree of renal impairment (RI) and about 25% of patients will experience RI at later disease stages. Patients with MM and RI have poorer overall survival and are at higher risk of early death.
  
  
  METHODS
  The mechanisms of acute renal damage in MM are covered and the issues around diagnosis and renal evaluation response are discussed. The importance of optimal supportive care is stressed and the role and effectiveness of different anti-myeloma agents covered including the role of high cut-off hemodialysis, autologous stem cell transplantation and kidney transplant. Expert commentary: Outcomes of patients with RI and rates of renal recovery have improved with the use of novel anti-myeloma agents. Bortezomib-dexamethasone backbone regimes (±third agent) are the current first choice in newly diagnosed patients. In relapsed/refractory disease additional treatment options include newer novel agents.
authors.affiliation: a Department of Clinical Therapeutics , National and Kapodistrian University of Athens, School of Medicine , Athens , Greece.
authors.forename: Despoina
authors.initials: D
authors.lastname: Fotiou
authors.affiliation: a Department of Clinical Therapeutics , National and Kapodistrian University of Athens, School of Medicine , Athens , Greece.
authors.forename: Meletios A
authors.initials: MA
authors.lastname: Dimopoulos
authors.affiliation: a Department of Clinical Therapeutics , National and Kapodistrian University of Athens, School of Medicine , Athens , Greece.
authors.forename: Efstathios
authors.initials: E
authors.lastname: Kastritis
mesh_terms: D000465:Algorithms; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D019468:Disease Management; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D016030:Kidney Transplantation; D009101:Multiple Myeloma / Q000150:complications* / Q000628:therapy; D010951:Plasma Exchange; D011379:Prognosis; D006435:Renal Dialysis; D014182:Transplantation, Autologous
keywords: IMiDs; Multiple myeloma; bortezomib; carfilzomib; high-cut off hemodialysis; myeloma cast nephropathy; renal impairment