Letter to the Editor
Experience of using haemodialysis with medium cut-off dialyser in cast nephropathy
Experiencia de hemodiálisis con dializador de mediano poro en la nefropatía por cilindros del mieloma
Juan Manuel Cazorla López
, Ana García García-Doncel, Javier Naranjo Muñoz, Florentino Villanego Fernández, Luis Alberto Vigara Sánchez, Manuel Ceballos Guerrero
Corresponding author
Servicio de Nefrología, Hospital Universitario Puerta del Mar, Cádiz, Spain
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"mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 742 "Ancho" => 2433 "Tamanyo" => 100560 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Weekly evolution of kappa light chain levels, pre- and post-dialysis.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Multiple myeloma is a clonal proliferation of plasma cells that causes kidney involvement in 40% of cases, although only 12–15% of cases start with acute kidney failure, with cast nephropathy being the most common cause of this. When acute kidney failure occurs, it requires chemotherapy treatment as well as apheresis techniques in a high percentage of cases<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">1,2</span></a> aimed at reducing the concentration of free light chains (FLC) in plasma as early as possible, and thereby preventing their deposition in the kidney tubules.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">3,4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The emergence of high cut-off haemodialysis (HCO-HD) was postulated as a breakthrough compared to conventional high-flux haemodialysis (HF-HD) due to a faster withdrawal of circulating FLCs. However, preliminary results from two recent studies generate a certain level of controversy.<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">5,6</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Recently, medium cut-off (MCO) membranes have been developed, with an ability to eliminate molecules like the HCOs, but able to retain albumin,<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">7–9</span></a> which may be a more cost-effective alternative for the adjuvant treatment of acute kidney failure due to kappa myeloma.</p><p id="par0020" class="elsevierStylePara elsevierViewall">We describe the cases of three patients who developed acute kidney failure secondary to kappa FLC tubular deposition (22.5<span class="elsevierStyleHsp" style=""></span>kDa). In all of them, chemotherapy treatment was started early with bortezomib and dexamethasone, according to the haematology protocol, as well as 6-h haemodialysis sessions with the MCO dialyser Theranova 500® by Baxter.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The weekly determination of pre-dialysis creatinine, of FLC kappa (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) and of albumin before and after each haemodialysis session (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) was carried out.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Case 1</span><p id="par0030" class="elsevierStylePara elsevierViewall">A 46-year-old woman in whom hypercalcaemia was detected (15.6<span class="elsevierStyleHsp" style=""></span>mg/dl), kappa FLC levels of 48,900<span class="elsevierStyleHsp" style=""></span>mg/l and deterioration of kidney function (creatinine of 10.3<span class="elsevierStyleHsp" style=""></span>mg/dl). The diagnosis of multiple myeloma was confirmed by bone marrow biopsy (76% of plasma cells).</p><p id="par0035" class="elsevierStylePara elsevierViewall">After 27 sessions of haemodialysis, kidney function remained stable without the need for dialysis and undetectable FLC levels.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Case 2</span><p id="par0040" class="elsevierStylePara elsevierViewall">A 72-year-old male with acute kidney failure (creatinine 4.7<span class="elsevierStyleHsp" style=""></span>mg/dl) and elevated kappa FLC levels (1040<span class="elsevierStyleHsp" style=""></span>mg/l). The diagnosis of multiple myeloma was confirmed in a bone marrow biopsy with 14.37% of plasma cells.</p><p id="par0045" class="elsevierStylePara elsevierViewall">The dialysis sessions were spaced out over time according to the analysis. After 32 sessions, the plasma creatinine levels stabilised around 3.4<span class="elsevierStyleHsp" style=""></span>mg/dl, without the need for dialysis.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Case 3</span><p id="par0050" class="elsevierStylePara elsevierViewall">A 73-year-old male who presented with acute kidney failure (creatinine 4.6<span class="elsevierStyleHsp" style=""></span>mg/dl), hypercalcaemia (Ca 11.5<span class="elsevierStyleHsp" style=""></span>mg/dl), hyperproteinaemia (14.11<span class="elsevierStyleHsp" style=""></span>g/dl) and kappa FLC levels of 14,300<span class="elsevierStyleHsp" style=""></span>mg/l. The diagnosis of multiple myeloma was confirmed by bone marrow biopsy with 28.66% of plasma cells.</p><p id="par0055" class="elsevierStylePara elsevierViewall">He received seven haemodialysis sessions after which the free light chain levels were reduced to 340<span class="elsevierStyleHsp" style=""></span>mg/l, and kidney function recovered to maintain creatinine levels of 1.4<span class="elsevierStyleHsp" style=""></span>mg/dl, without new dialysis sessions.</p><p id="par0060" class="elsevierStylePara elsevierViewall">In the three cases described, a sustained decrease in kappa chain concentration pre- and post-dialysis was observed, with a mean reduction of 44.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>19.5% in each session, without a significant reduction in the plasma albumin levels. All the patients recovered kidney function without the need for more dialysis sessions.</p><p id="par0065" class="elsevierStylePara elsevierViewall">The development of new chemotherapy treatments and of apheresis, and their early administration has led to an improvement in survival and has increased the renal recovery rate in patients affected by acute kidney failure secondary to cast nephropathy. With the development of haemodialysis with new dialysers, firstly HCO-HD and subsequently MCO-HD, there has been an attempt to improve these results.</p><p id="par0070" class="elsevierStylePara elsevierViewall">Preliminary results of two multicentre, randomised and controlled studies which compare chemotherapy treatment along with HF-HD or HCO-HD deliver contradictory results; while better renal outcomes for patients are shown in the MYRE study,<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">6</span></a> the EULITE study<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">5</span></a> does not provide statistically significant results. The study of the complete results will be necessary to understand the reason for these differences.</p><p id="par0075" class="elsevierStylePara elsevierViewall">From our experience, the introduction of haemodialysis with medium cut-off dialysers has managed to reduce the loss of albumin which was produced with previous high cut-off dialysers, without this influencing the rapid and effective reduction of the plasma concentration of kappa light chains, obtaining good clinical outcomes and renal survival in treated patients.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Case 1" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Case 2" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Case 3" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Cazorla López JM, García García-Doncel A, Naranjo Muñoz J, Villanego Fernández F, Vigara Sánchez LA, Ceballos Guerrero M. Experiencia de hemodiálisis con dializador de mediano poro en la nefropatía por cilindros del mieloma. Nefrologia. 2020;40:367–369.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 742 "Ancho" => 2433 "Tamanyo" => 100560 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Weekly evolution of kappa light chain levels, pre- and post-dialysis.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 915 "Ancho" => 2137 "Tamanyo" => 85224 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Weekly evolution of plasma albumin levels, pre- and post-dialysis.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0050" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Immunoglobulin free light chain levels and recovery from myeloma kidney on treatment with chemotherapy and high cut-off haemodialysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Hutchison" 1 => "N. Heyne" 2 => "P. Airia" 3 => "R. Schindler" 4 => "D. Zickler" 5 => "M. Cook" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/ndt/gfr773" "Revista" => array:5 [ "tituloSerie" => "Nephrol Dial Transp" "fecha" => "2012" "volumen" => "27" "paginaInicial" => "3823" "paginaFinal" => "3828" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0055" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of high-cutoff hemodialysis vs conventional hemodialysis on hemodialysis independence among patients with myeloma cast nephropathy: a randomized clinical trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Bridoux" 1 => "P.L. Carron" 2 => "B. Pegourie" 3 => "E. Alamartine" 4 => "K. Augeul-Meunier" 5 => "A. Karras" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jama.2017.17924" "Revista" => array:7 [ "tituloSerie" => "JAMA" "fecha" => "2017" "volumen" => "318" "paginaInicial" => "2099" "paginaFinal" => "2110" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29209721" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1695403315005500" "estado" => "S300" "issn" => "16954033" ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0060" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nuevas alternativas en el tratamiento del riñón del mieloma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.A. Álvarez-Lara" 1 => "A. Martín-Malo" 2 => "P. Aljama-García" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3265/Nefrologia.pre2013.Jun.12138" "Revista" => array:6 [ "tituloSerie" => "Nefrologia" "fecha" => "2013" "volumen" => "33" "paginaInicial" => "443" "paginaFinal" => "447" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23897175" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0065" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tratamiento con hemodiálisis del fracaso renal agudo en el mieloma múltiple con filtros de alto poro (high cut-off)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Martín-Reyes" 1 => "Toledo-Rojas" 2 => "A. Torres-de Rueda" 3 => "E. Sola-Moyano" 4 => "L. Blanca-Martos" 5 => "L. Fuentes-Sánchez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3265/Nefrologia.pre2011.Nov.11094" "Revista" => array:6 [ "tituloSerie" => "Nefrologia" "fecha" => "2012" "volumen" => "32" "paginaInicial" => "35" "paginaFinal" => "43" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22294003" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0070" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "High cut-off haemodialysis (HCO-HD) does not improve outcomes in myeloma cast nephropathy: results of European Trial of Free Light Chain Removal by Extended Haemodialysis in Cast Nephropathy (EULITE)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M. Cook" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:3 [ "titulo" => "Paper presented at the Twenty first European Hematology Association Congress" "conferencia" => "Copenhagen, Denmark" "serieFecha" => "2016, June" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0075" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of high-cutoff hemodialysis vs conventional hemodialysis on hemodialysis independence among patients with myeloma cast nephropathy: a randomized clinical trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Bridoux" 1 => "P. Carron" 2 => "B. Pegourie" 3 => "E. Alamartine" 4 => "K. Augeul-Meunier" 5 => "A. Karras" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jama.2017 17924" "Revista" => array:6 [ "tituloSerie" => "JAMA" "fecha" => "2017" "volumen" => "318" "paginaInicial" => "2099" "paginaFinal" => "2110" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29209721" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0080" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Performance of hemodialysis with novel medium cut-off dialyzers" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.H. Kirsch" 1 => "R. Lyko" 2 => "L.G. Nilsson" 3 => "W. Beck" 4 => "M. Amdahl" 5 => "P. Lechner" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/ndt/gfw310" "Revista" => array:6 [ "tituloSerie" => "Nephrol Dial Transplant" "fecha" => "2016" "volumen" => "32" "paginaInicial" => "165" "paginaFinal" => "172" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27587605" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0085" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "MCO membranes: enhanced selectivity in high-flux class" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Boschetti-de-Fierro" 1 => "M. Voigt" 2 => "M. Storr" 3 => "B. Krause" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/srep18448" "Revista" => array:5 [ "tituloSerie" => "Sci Rep" "fecha" => "2015" "volumen" => "5" "paginaInicial" => "18448" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26669756" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0090" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "El dializador en el año 2017; mucho más que una membrana" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R. Pérez-García" 1 => "R. Alcázar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.nefro.2017.08.003" "Revista" => array:7 [ "tituloSerie" => "Nefrología" "fecha" => "2018" "volumen" => "38" "paginaInicial" => "4" "paginaFinal" => "7" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29122381" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S169540331300369X" "estado" => "S300" "issn" => "16954033" ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/20132514/0000004000000003/v1_202007190656/S2013251420300730/v1_202007190656/en/main.assets" "Apartado" => array:4 [ "identificador" => "35436" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/20132514/0000004000000003/v1_202007190656/S2013251420300730/v1_202007190656/en/main.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2013251420300730?idApp=UINPBA000064" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 13 | 9 | 22 |
| 2024 October | 67 | 35 | 102 |
| 2024 September | 80 | 60 | 140 |
| 2024 August | 96 | 60 | 156 |
| 2024 July | 57 | 33 | 90 |
| 2024 June | 73 | 44 | 117 |
| 2024 May | 62 | 41 | 103 |
| 2024 April | 71 | 44 | 115 |
| 2024 March | 63 | 35 | 98 |
| 2024 February | 65 | 46 | 111 |
| 2024 January | 48 | 27 | 75 |
| 2023 December | 52 | 45 | 97 |
| 2023 November | 74 | 42 | 116 |
| 2023 October | 107 | 34 | 141 |
| 2023 September | 97 | 37 | 134 |
| 2023 August | 117 | 29 | 146 |
| 2023 July | 140 | 31 | 171 |
| 2023 June | 90 | 27 | 117 |
| 2023 May | 107 | 31 | 138 |
| 2023 April | 78 | 16 | 94 |
| 2023 March | 89 | 22 | 111 |
| 2023 February | 62 | 25 | 87 |
| 2023 January | 56 | 35 | 91 |
| 2022 December | 81 | 45 | 126 |
| 2022 November | 67 | 41 | 108 |
| 2022 October | 72 | 48 | 120 |
| 2022 September | 71 | 57 | 128 |
| 2022 August | 53 | 54 | 107 |
| 2022 July | 71 | 91 | 162 |
| 2022 June | 84 | 55 | 139 |
| 2022 May | 79 | 36 | 115 |
| 2022 April | 111 | 56 | 167 |
| 2022 March | 88 | 60 | 148 |
| 2022 February | 79 | 51 | 130 |
| 2022 January | 55 | 45 | 100 |
| 2021 December | 48 | 51 | 99 |
| 2021 November | 107 | 49 | 156 |
| 2021 October | 161 | 82 | 243 |
| 2021 September | 87 | 56 | 143 |
| 2021 August | 90 | 54 | 144 |
| 2021 July | 51 | 50 | 101 |
| 2021 June | 51 | 31 | 82 |
| 2021 May | 90 | 63 | 153 |
| 2021 April | 116 | 56 | 172 |
| 2021 March | 96 | 37 | 133 |
| 2021 February | 65 | 47 | 112 |
| 2021 January | 32 | 21 | 53 |
| 2020 December | 46 | 22 | 68 |
| 2020 November | 25 | 17 | 42 |
| 2020 October | 28 | 23 | 51 |
| 2020 September | 67 | 31 | 98 |
| 2020 August | 311 | 28 | 339 |
| 2020 July | 47 | 18 | 65 |
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