Novel Treatments in Improving Renal Outcomes in Light Chain Cast Nephropathy

Prior treatment

• Patients who did not receive clone-directed therapy for myeloma
• Patients who received plasma exchange \>30 days from the time of diagnosis of cast nephropathy

Other illness

• Patients with end stage kidney disease
• Patients with amyloidosis or monoclonal immunoglobulin deposition disease
• Moribund condition (e.g., patients who died within 48 hours of initiation of plasma exchange)

Other

• Patients with chronic lymphocytic leukemia, plasma cell leukemia, or Waldenstrom's
• Active urinary tract obstruction on renal imaging
• Patients with significant albuminuria (≥2+ on urinary dipstick or \>10% fraction on UPEP)
• Patients with other biopsy-proven causes of AKI (non-cast nephropathy lesions)

• Adult (≥18 years old)
• Either a new diagnosis of multiple myeloma confirmed by bone marrow plasmayctosis \>10% or acute relapse of multiple myeloma
• Light chain cast nephropathy, with involved light chain \>500 mg/L
• Acute kidney injury, defined as ≥1.5-fold rise in SCr from baseline (as defined in study outcomes) or the need for renal replacement therapy (RRT).
• Treated with at least 1 round of plasma exchange within 30 days of diagnosis of cast nephropathy
• Treated with plasma exchange in 2010 or later
• Adult (≥18 years old)
• Either a new diagnosis of multiple myeloma confirmed by bone marrow plasmayctosis \>10% or acute relapse of multiple myeloma
• Light chain cast nephropathy, with involved light chain \>500 mg/L
• Acute kidney injury, defined as ≥1.5-fold rise in SCr from baseline or the need for renal replacement therapy (RRT)