Renal Prognostic Benefit of High Cut Off Dialysis Membrane Treatment in the Management of Dialysis-Dependent Severe Acute Renal Failure Secondary to Myeloma Cast Nephropathy in a Local Cohort

Introduction:The objective of this observational study on a local cohort was to report the prognostic interest of using a High Cut-Off membrane dialysis protocol in the management of MM (myeloma tubulopathy) in patients with severe dialysis-dependent acute kidney injury (AKI).Methodology: This was a retrospective study conducted over a one-year period from September 1, 2023, to August 31, 2024.All hospitalized patients with dialysis-dependent AKI diagnosed with MM were treated according to the High Cut-Off protocol of usual chemotherapy.A free light chain proteinuria level above 1500 mg/L was required to confirm the diagnosis of MM.Results: In our cohort, we included 14 patients diagnosed with MM, 9 of whom were treated with the High Cut-Off protocol.Among these, 5 recovered renal function (RF), and 4 did not; 5 patients underwent conventional dialysis without RF recovery.The average age was 77 years, ranging from 45 to 92 years, with the highest age group being 65 to 85 years.Women were predominant, with a sex ratio of 1.4.The hematological diagnosis was similar in all groups (HCO+, HCO-, and conventional dialysis).Our results show a higher percentage of patients with subacute MM or pre-existing chronic kidney disease (CKD) in the HCO+ group, with mean creatinine levels of 133 mol/L, 117 mol/L, and 106.5 mol/L, respectively.No patient with creatinine > 115 mol/L was found in the HCO+ group, while there were 3/5 (60%) in the HCO-group and 5 in the conventional dialysis group.A significant decrease in free light chain levels was observed at the end of the pro-How to cite this paper: