By reducing the plasma concentration of nephrotoxic myeloma paraproteins, plasmapheresis could promote recovery of renal function and lessen the need for chronic dialysis in patients with myeloma cast nephropathy. Weighing up the findings and limitations of the three randomized controlled trials of plasmapheresis conducted to date in myeloma cast nephropathy, the author considers whether there is, or might be in future, a place for it in this setting.
