For many years standard therapy for cast nephropathy has been plasma exchange.
R, Cockwell, P, (2008) European Trial of Free Light Chain Removal by Extended Haemodialysis in Cast Nephropathy (EuLITE): A Randomised control Trial, In Trials 2008, 9, 55
Leung, N, Gertz, MA, Zeldenrust, SR, Rajkumar, RSV, Dispenzieri, A, Fervenza FC, Kumar, S, Lacy, MQ, Lust, JA, Greipp, PR, Witzig, TE, Hayman SR, Russell, SJ, Kyle, RA, Winters, JL, (2008) Improvement of cast nephropathy with plasma exchange depends on the diagnosis and on reduction of serum free light chains, Kidney International, 73, 1282-1288
16-19) Light chain cast nephropathy has been traditionally considered the most common pattern of renal damage in patients with plasma cell dyscrasias.
Manifestations at the light microscopic level diagnostic of light chain (myeloma) cast nephropathy may be difficult to assess with certainty.
For example, patients with plasma cell dyscrasias with certain types (not any kind) of circulating light chains who become dehydrated, hypercalcemic, or are given loop diuretics, such as furosemide, increase significantly their risk of developing light chain cast nephropathy.
The kidney in plasma cell dyscrasias: Bence-Jones cast nephropathy and light chain deposit disease.