AJKD Atlas of Renal Pathology: Light Chain Cast Nephropathy

      Patients with light chain cast nephropathy are often middle-aged or older and present with acute kidney injury. They typically have overt multiple myeloma at the time of diagnosis. Conversely, about half of patients with multiple myeloma and kidney disease have light chain cast nephropathy. There is associated nephrotic-range proteinuria, composed largely of light chains. The lesser albuminuria can manifest as low-level proteinuria by dipstick analysis. Patients may also have additional AL amyloid or monoclonal immunoglobulin deposition disease.
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