{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T01:37:53Z","timestamp":1789004273791,"version":"build-2803163510"},"reference-count":80,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,10,26]],"date-time":"2022-10-26T00:00:00Z","timestamp":1666742400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Multiple myeloma (MM), an incurable hematological malignancy with clonal proliferation of plasma cells, is mainly characterized by excessive production of monoclonal immunoglobulins and free light chains (FLCs). Kidney injury is one of the main clinical manifestations and is also a significant predictor of the prognosis of symptomatic MM patients, especially those who require dialysis-supported treatment. Overproduction of FLCs is the trigger for kidney injury, as they can induce the transcription of inflammatory and profibrotic cytokines in the proximal tubule and bind to Tamm\u2013Horsfall protein in the distal tubules to form casts that obstruct the tubules, leading to kidney injury and even renal fibrosis. In addition to traditional antimyeloma treatment, high-cutoff hemodialysis (HCO-HD), which can effectively remove FLCs <jats:italic>in vitro<\/jats:italic>, has attracted much attention in recent years. Due to its greater membrane pore size, it has significant advantages in removing larger molecules and can be applied in rhabdomyolysis, sepsis, and even myeloma cast nephropathy. However, mounting questions have recently been raised regarding whether HCO-HD can truly provide clinical benefits in MM patients with acute kidney injury (AKI). Therefore, in this study, we discussed the pathological causes of AKI secondary to MM and summarized the current situation of HCO-HD in MM patients compared with other available extracorporeal techniques. In addition, pivotal clinical trials that reflect the ability of the clearance of FLCs and the side effects of HCO-HD are highlighted, and the relevant protocol of HCO-HD is also provided to assist clinicians in decision-making.<\/jats:p>","DOI":"10.3389\/fonc.2022.1024133","type":"journal-article","created":{"date-parts":[[2022,10,26]],"date-time":"2022-10-26T15:26:30Z","timestamp":1666797990000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["High-cutoff hemodialysis in multiple myeloma patients with acute kidney injury"],"prefix":"10.3389","volume":"12","author":[{"given":"Yan","family":"Xing","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jipeng","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zixian","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuwei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiayin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunlong","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiren","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,10,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"17046","DOI":"10.1038\/nrdp.2017.46","article-title":"Multiple myeloma","volume":"3","author":"Kumar","year":"2017","journal-title":"Nat Rev Dis Primers"},{"key":"B2","doi-asserted-by":"publisher","first-page":"21","DOI":"10.4065\/78.1.21","article-title":"Review of 1027 patients with newly diagnosed multiple myeloma","volume":"78","author":"Kyle","year":"2003","journal-title":"Mayo Clin Proc"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1011442","article-title":"Multiple myeloma","volume":"364","author":"Palumbo","year":"2011","journal-title":"N Engl J Med"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2020.11.010","article-title":"Management of acute kidney injury in symptomatic multiple myeloma","volume":"99","author":"Bridoux","year":"2021","journal-title":"Kidney Int"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2018.2128","article-title":"Global burden of multiple myeloma: A systematic analysis for the global burden of disease study 2016","volume":"4","author":"Cowan","year":"2018","journal-title":"JAMA Oncol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1002\/cncr.22850","article-title":"Epidemiology of multiple myeloma in Taiwan: Increasing incidence for the past 25 years and higher prevalence of extramedullary myeloma in patients younger than 55 years","volume":"110","author":"Huang","year":"2007","journal-title":"Cancer"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-07-298760","article-title":"Racial disparities in incidence and outcome in multiple myeloma: A population-based study","volume":"116","author":"Waxman","year":"2010","journal-title":"Blood"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.0003","article-title":"Diagnosis and management of multiple myeloma: A review","volume":"327","author":"Cowan","year":"2022","journal-title":"Jama"},{"key":"B9","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1093\/annonc\/mdt483","article-title":"Significant improvement in the survival of patients with multiple myeloma presenting with severe renal impairment after the introduction of novel agents","volume":"25","author":"Dimopoulos","year":"2014","journal-title":"Ann Oncol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0101819","article-title":"The use of novel drugs can effectively improve response, delay relapse and enhance overall survival in multiple myeloma patients with renal impairment","volume":"9","author":"Uttervall","year":"2014","journal-title":"PloS One"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfp488","article-title":"Presentation and survival of patients with severe acute kidney injury and multiple myeloma: A 20-year experience from a single centre","volume":"25","author":"Haynes","year":"2010","journal-title":"Nephrol Dial Transplant"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0609.2000.90221.x","article-title":"Renal failure in multiple myeloma: Reversibility and impact on the prognosis. 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