GuidelineJournal of nephrology2016
Light chains removal by extracorporeal techniques in acute kidney injury due to multiple myeloma: a position statement of the Onconephrology Work Group of the Italian Society of Nephrology.
Guideline in Journal of nephrology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- Guidelines on the Use of Therapeutic Apheresis in Clinical Practice-Evidence-Based Approach From the Writing Committee of the American Society for Apheresis: The Tenth Special Issue.Journal of clinical apheresis · 2026Guideline
- Prognosis of concurrent renal impairment at diagnosis of multiple myeloma: a systematic review.Annals of medicine · 2024Pooled it
- Extracorporeal Free-Light-Chain Removal in Myeloma Cast Nephropathy: Plasma Exchange and Hemodialysis Strategies in the Era of Effective Antimyeloma Therapy.Journal of clinical medicine · 2026Review
- Cast nephropathy in the ICU: Early recognition and extracorporeal strategies to improve outcomes.Journal of intensive medicine · 2026Review
- Article
- Role of light chain clearance in the recovery of renal function in multiple myeloma: another point of view.Clinical kidney journal · 2023Article
- Review
- Management of acute kidney injury in frail patients with biopsy-proven cast nephropathy: a combined approach with chemotherapy plus Supra-hemodiafiltration with post-adsorption endogenous reinfusion.Journal of nephrology · 2022Article
- High-cutoff hemodialysis in multiple myeloma patients with acute kidney injury.Frontiers in oncology · 2022Review
- Therapeutic Plasma Exchange: For Cancer Patients.Cancer management and research · 2022Review
- Light Chain Cast Nephropathy in Multiple Myeloma: Prevalence, Impact and Management Challenges.International journal of nephrology and renovascular disease · 2022Review
- Acute Kidney Injury in Monoclonal Gammopathies.Journal of clinical medicine · 2021Review
- Multiple Myeloma Mimicking a Small Vessel Vasculitis Presentation.Case reports in rheumatology · 2020Article
- Lithium increases ammonium excretion leading to altered urinary acid-base buffer composition.Journal of nephrology · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Acute kidney injury (AKI) is a frequent complication of multiple myeloma and is associated with increased short-term mortality. Additionally, even a single episode of AKI can eventually lead to end-stage renal disease (ESRD), significantly reducing quality of life and long-term survival. In the setting of multiple myeloma, severe AKI (requiring dialysis) is typically secondary to cast nephropathy (CN). Renal injury in CN is due to intratubular obstruction from precipitation of monoclonal serum free light chains (sFLC) as well as direct tubular toxicity of sFLC via stimulation of nuclear factor (NF)κB inflammatory pathways. Current mainstays of CN treatment are early removal of precipitating factors such as nephrotoxic drugs, acidosis and dehydration, together with rapid reduction of sFLC levels. Introduction of the proteasome inhibitor bortezomib has significantly improved the response rates in multiple myeloma due to its ability to rapidly reduce sFLC levels and has been referred to as "renoprotective" therapy. As an adjunct to chemotherapy, several new extracorporeal techniques have raised interest as a further means to reduce sFLC concentrations in the treatment of CN. Whether addition of extracorporeal therapies to renoprotective therapy can result in better renal recovery is still a matter of debate and there are currently no guidelines in this field. In this positon paper, we offer an overview of the available data and the authors' perspectives on extracorporeal treatments in CN.
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Registered trials
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