Myeloma cast nephropathy, also referred to as light-chain cast nephropathy, is the formation of plugs (urinary casts) in the kidney tubules from free immunoglobulin light chains leading to kidney failure in the context of multiple myeloma.

[1] In myeloma cast nephropathy, filtered κ or λ light chains that bind to Tamm-Horsfall protein precipitate in the kidney's tubules.

Hypercalcemia and low fluid intake contribute to the development of casts.

[2] Myeloma cast nephropathy is considered to be a medical emergency because if untreated, it leads to irreversible kidney failure.

[1] It is diagnosed by histological examination of kidney biopsy.