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高截留量血液透析（ HCO）是近年来血液透析领域重要的研究进展之一，其可有效清除相对分子质量为65000的物质，主要用于治疗骨髓瘤管型肾病、脓毒症、横纹肌溶解征等疾病。骨髓瘤患者由于游离轻链被近曲小管吸收后沉积在上皮细胞胞质内，使肾小管细胞变性，导致急性肾衰竭。大量临床试验证明，HCO可有效清除游离轻链，促进肾功能恢复，改善患者预后。该文就 HCO在多发性骨髓瘤管型肾病中的临床应用进展作一简述。“,”High cut-off hemodialysis( HCO) is one of the important studies in field of hemodialysis in recent years,which can effectively remove substances of relative molecular 65 000,mainly used in the treat-ment of myeloma cast nephropathy,sepsis andrhabdomyolysis syndrome.In myeloma patients,free light chain ( FLC) uptake by proximal tubule cells and deposition in the epithelial cell cytopiasm ,lead to renal tubular cell degeneration and acute renal failure.A large number of clinical trials have demonstrated that HCO can effectively remove FLC ,promote the recovery of renal function and improve the prognosis of the patients .Here is to summarize the application of HCO in myeloma cast nephropathy.