Evaluation of Blood Purification and Bortezomib Plus Dexamethasone Therapy for the Treatment of Acute Renal Failure Due to Myeloma Cast Nephropathy

摘要

Aggressive removal of circulating free light chains (FLC) by blood purification accompanied by chemotherapy is a promising approach for the treatment of acute renal failure due to myeloma cast nephropathy. Plasma exchange has been performed to remove serum FLC; in order to examine an alternative strategy we performed hemodiafiltration using protein-leaking dialyzers for the treatment of dialysis-dependent acute renal failure due to myeloma cast nephropathy. In the first case with K-light chain cast nephropathy, the pre-treatment serum creatinine was 9.65 mg/dL, and the serum k-FLC was 27 100 mg/L. Plasma exchange or hemodiafiltration was performed from Monday to Friday during the first several weeks.