2005
DOI: 10.7326/0003-4819-143-11-200512060-00005
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Abstract: In patients with acute renal failure at the onset of multiple myeloma, there is no conclusive evidence that 5 to 7 plasma exchanges substantially reduce a composite outcome of death, dialysis dependence, or glomerular filtration rate less than 0.29 mL.s(-2).m(-2) (<30 mL/min per 1.73 m2) at 6 months.

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Cited by 292 publications
(169 citation statements)
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“…45 On the other hand, a large randomized trial showed no conclusive evidence that plasma exchange improved the outcome in patients with MM and acute renal failure. 46 However, in this study, patients did not need to have kidney biopsies performed, so patients with amyloidosis, LCDD or Fanconi's may have been included, thus underestimating the benefit of plasma exchange. Because free light chain measurement was not available in this study, the possibility that a subgroup of patients might benefit from plasma exchange cannot be ruled out.…”
Section: Supportive Carementioning
confidence: 97%
See 1 more Smart Citation
“…45 On the other hand, a large randomized trial showed no conclusive evidence that plasma exchange improved the outcome in patients with MM and acute renal failure. 46 However, in this study, patients did not need to have kidney biopsies performed, so patients with amyloidosis, LCDD or Fanconi's may have been included, thus underestimating the benefit of plasma exchange. Because free light chain measurement was not available in this study, the possibility that a subgroup of patients might benefit from plasma exchange cannot be ruled out.…”
Section: Supportive Carementioning
confidence: 97%
“…1,2,5,38,46 Conventional chemotherapy with alkylating agents, such as melphalan prednisone (MP), results in moderate rates of renal function recovery, whereas it is complicated by the need for dose adjustment, which may in turn result in suboptimal treatment. 54 In the study of Alexanian et al, 1 after administration of chemotherapy with alkylating agents, doxorubicin and steroids, 51% of patients recovered renal function (defined as a sustained decrease of creatinine o1.4 mg per 100 ml) within a median of 1.2 months.…”
Section: Conventional Chemotherapymentioning
confidence: 99%
“…Despite these advantages, many clinicians are reluctant to perform percutaneous renal biopsies in patients with paraproteins because of the theoretical risk of a higher rate of hemorrhagic complications (8,9). Indeed, there are a number of mechanisms by which paraproteins might confer this increased risk (10,11).…”
mentioning
confidence: 99%
“…Evidence of the benefit of plasma exchange in removing serum free light chains (sFLC) has been controversial [1,2]. According to our recent experience, high cut-off hemodialysis (HCOD) with specially designed dialyzers reduces the level of sFLC concentration within hours and improves renal function in MCN in the long term when combined with effective bortezomib-based chemotherapy.…”
mentioning
confidence: 99%