- 期刊
- OpenAccess
Light Chain Cast Nephropathy Treated With High Cut-Off Dialyzers in Taiwan-Case Report
摘要
The rapid clearance of serum free light chain (FLC) has been associated with improved kidney outcome in myeloma kidney. Extracorporeal removal of serum FLC with high cut-off (HCO) dialyzers has been shown to be of good efficacy. We reported a case of multiple myeloma patient presenting with dialysis-requiring acute kidney injury who was treated with extended hemodialysis (HD) sessions using HCO dialyzers. Nine extended HD sessions, 5 daily sessions and then 3 times a week, of 8 hours each was performed with the use of one Theralite® dialyzer each session. Mean clearance ratios per session were 72% (range = 58-82%) for lambda chain, 71% (range = 59-83%) for kappa chain, and 59.4% (range = 58-76.9%) for β2-microglobulin. Dramatic reduction of serum free lambda light chains, from a maximum predialysis level of 4,469.0 mg/dL to a predialysis level of 119.4 mg/dL, was recorded after 9 sessions of extended HD with HCO dialyzers and 4 doses of bortezomib-based chemotherapy. The patient succumbed to severe respiratory infection and expired. A review of literature was also included in the discussion.
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