This document discusses high cut off dialysis for treating renal impairment caused by monoclonal immunoglobulin light chains (FLCs) in patients with multiple myeloma. It covers: - FLCs can cause kidney damage through various mechanisms like cast nephropathy when they precipitate in the kidneys - High cut off dialysis is more effective at removing FLCs than conventional dialysis due to its larger pore size membranes - For patients with acute kidney injury from cast nephropathy, aggressive high cut off dialysis along with chemotherapy can reduce FLC levels and renal function in many patients, allowing dialysis independence.