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Extended high cut‐off haemodialysis for myeloma cast nephropathy in Auckland, 2008–2012

Myeloma cast nephropathy contributes to high morbidity and early mortality associated with the development of end‐stage renal disease. Treatment with extended high cut‐off haemodialysis coupled with novel anti‐myeloma therapies enables significant reduction of serum‐free light chains and has been shown to improve renal outcomes. In this case series, medical records of 6 patients who received high cut‐off haemodialysis for biopsy‐proven cast nephropathy were retrospectively reviewed. Patients received a total of 344 hours of high cut‐off haemodialysis and concurrent chemotherapy. Only 50% became dialysis independent following treatment. One patient who achieved sustained remission remained dialysis dependent. The added benefit of high cut‐off haemodialysis in the light of novel anti‐myeloma therapies requires further evaluation.