Recovery of kidney function following delayed use of theralite™ dialyzer in a patient with myeloma cast nephropathy

Khagendra Dahal, Shani Shastri, Uma Narayanasami, Vanesa Bijol, Karen Rider, James A. Strom, Bertrand L. Jaber

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

We report the case of a 60- year- old man who presented with newly diagnosed multiple myeloma complicated by biopsy-proven acute cast nephropathy, requiring hemodialysis, plasmapheresis and chemotherapy. After remaining dialysis dependent for 5 weeks, a high cut-off (HCO) dialyzer, intended to use for the removal of plasma substances with a molecular weight of up to 45 kDa such as free light chains, was introduced to his outpatient 4-hour hemodialysis regimen with an increase in treatment frequency to 4 sessions per week. Following 6 weeks of dialysis with the HCO dialyzer, serum levels of free κ light chains declined by more than 75%. Concurrently, he recovered kidney function and discontinued dialysis. He subsequently received a successful autologous stem-cell transplant. We discuss the potential merit of using the HCO dialyzer late in the course of the care of patients with myeloma cast nephropathy who are dialysis dependent.

Original languageEnglish (US)
Pages (from-to)318-322
Number of pages5
JournalClinical Nephrology
Volume79
Issue number4
DOIs
StatePublished - Apr 1 2013

Keywords

  • Acute kidney injury
  • Cast nephropathy
  • Hemodialysis
  • High cut-off dialyzer
  • Myeloma
  • Theralite

ASJC Scopus subject areas

  • Nephrology

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