Renal Failure Due to Multiple Myeloma

Approximately 20% of patients with multiple myeloma develop progressive kidney failure during the course of the disease. The accumulation of numerous monoclonal chains in renal parenchyma cells is usually correlated with renal failure in a patient with myeloma cancer. These light chains interact with Tamm-Horsfall protein in the distal convoluted tubule, leading to cast formation and disruption of the tubular basement membrane, resulting in acute tubular interstitial nephritis. Therefore, sufficient hydration, maintaining elevated calcium and uric acid levels, and treatment with chemotherapeutic regimens are urgent in treating such patients. Treatment should be followed with medications like thalidomide, bortezomib, and lenalidomide to prevent the severity of the disease. In addition to that, significant consideration should be given to mechanical means of treatment such as hemodialysis, kidney filters to remove the light chain blood transfusion, and many more. According to recent research and development, more efforts must be made to improve kidney function in patients with multiple myeloma and renal failure.