Renal Toxicities of Novel Agents Used for Treatment of Multiple Myeloma

Clin J Am Soc Nephrol. 2017 Jan 6;12(1):176-189. doi: 10.2215/CJN.06100616. Epub 2016 Sep 21.


Survival for patients with multiple myeloma has significantly improved in the last decade in large part due to the development of proteasome inhibitors and immunomodulatory drugs. These next generation agents with novel mechanisms of action as well as targeted therapies are being used both in the preclinical and clinical settings for patients with myeloma. These agents include monoclonal antibodies, deacetylase inhibitors, kinase inhibitors, agents affecting various signaling pathways, immune check point inhibitors, and other targeted therapies. In some cases, off target effects of these therapies can lead to unanticipated effects on the kidney that can range from electrolyte disorders to AKI. In this review, we discuss the nephrotoxicities of novel agents currently in practice as well as in development for the treatment of myeloma.

Keywords: Acute Kidney Injury; Antibodies, Monoclonal; Coal Tar; Proteasome Inhibitors; Water-Electrolyte Imbalance; acute renal failure; cancer; chronic kidney disease; drug nephrotoxicity; electrolytes; humans; kidney; multiple myeloma.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / adverse effects
  • Antibodies, Monoclonal, Humanized / adverse effects*
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Bortezomib / adverse effects
  • Everolimus / adverse effects
  • Humans
  • Imidazoles / adverse effects
  • Immunologic Factors / adverse effects*
  • Indoles / adverse effects
  • Kidney Diseases / chemically induced*
  • Lenalidomide
  • Multiple Myeloma / drug therapy*
  • Nivolumab
  • Oligopeptides / adverse effects
  • Oximes / adverse effects
  • Proteasome Inhibitors / adverse effects*
  • Protein Kinase Inhibitors / adverse effects*
  • Sulfonamides / adverse effects
  • Thalidomide / adverse effects
  • Thalidomide / analogs & derivatives
  • Vemurafenib


  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents
  • Imidazoles
  • Immunologic Factors
  • Indoles
  • Oligopeptides
  • Oximes
  • Proteasome Inhibitors
  • Protein Kinase Inhibitors
  • Sulfonamides
  • elotuzumab
  • Vemurafenib
  • Nivolumab
  • Thalidomide
  • IPH-2101
  • Bortezomib
  • carfilzomib
  • Everolimus
  • pomalidomide
  • pembrolizumab
  • Lenalidomide
  • dabrafenib
  • siltuximab