Myeloma-Related Kidney Disease (Myeloma Kidney; Myeloma Cast Nephropathy) By Frank O'Brien, MD, Washington University in St Louis Reviewed / Revised Mar 2022 | Modified Sep 2022 View Patient Education Symptoms and Signs Diagnosis Prognosis Treatment Key Points Topic Resources Myeloma Kidney Patients with multiple myeloma overproduce monoclonal Ig light chains (Bence Jones proteins); these light chains are filtered by glomeruli, are nephrotoxic, and, in their various forms (free, tubular casts, amyloid), can damage virtually all areas of the kidney parenchyma.