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MERIT was a randomised clinical trial (RCT), set up to evaluate if mechanical reduction of elevated free light chain levels (FLC) would result in clinical benefit. Completion of the planned seven plasma exchanges (PEs) in the first 14 days failed to show, for the exchange group, a greater reduction in FLC or any improvement in dialysis independence at 100 days or subsequently. To improve prognosis for these patients requires earlier diagnosis and prompt anti\u2010myeloma therapy with effectiveness guided by frequent FLC monitoring.<\/jats:p>","DOI":"10.1002\/jha2.620","type":"journal-article","created":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T22:50:05Z","timestamp":1670453405000},"page":"246-250","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["What can we do about patients presenting with myeloma and severe renal failure? 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