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cast nephropathy
Etiology:
- multiple myeloma
- acute kidney injury
Pathology:
- nephrotoxic light chain are filtered & accumulate in the renal tubules resultin in tubular injury & formation of casts within the renal tubules
Laboratory:
- urine protein: proteinuria other than albuminuria
- urine protein electrophoresis
- monoclonal free light chains in urine
- urinalysis
- urinary casts
- bland urine sediment
- renal biopsy Mamagement:
- intravenous fluids
- avoidance of nephrotoxic agents
- chemotherapy to reduce free light chain burden [1]
- plasmapheresis clears free light chains inefficiently [1]
Related
urinary cast
General
nephropathy
References
- Medical Knowledge Self Assessment Program (MKSAP) 17,
American College of Physicians, Philadelphia 2015