Nevertheless, it seems very likely that this protein is involved in the development of cast nephropathy, formation of renal stones, immunologic defence in the kidney, as well as in the modulation of systemic immunologic events [31].
There was no evidence of myeloma cast nephropathy.
However, reversibility of renal function in cases other than cast nephropathy is largely unknown.
Tubulointerstitial injury is usually seen in cast nephropathy and glomerular injury is seen in amyloidosis.
These monoclonal FLCs often result in renal pathologies, most importantly cast nephropathy [ 4- 6].
The clinical presentation of cast nephropathy usually combines ARF and Bence-Jones proteinuria.
However, there were no changes indicating cast nephropathy or amyloidosis, which are often associated with myeloma.
Several factors may cause renal failure in myeloma patients, with cast nephropathy the most common cause.
Nephrologists are interested in a treatment strategy combining chemotherapy and extracorporeal treatments in patients with biopsy-proven cast nephropathy or a high probability of cast nephropathy (defined as >200 mg/dL on the FLC assay).
**One patient with known chronic lymphocytic leukaemia, in remission, presented with acute renal failure and biopsy proven cast nephropathy.
This so-called cast nephropathy is associated with reduced 1-year survival and limitation of therapeutical options [ 37].
