<prompt> Kidney changes in multiple myeloma are ?Hyaline castsFocal segmental glomerulosclerosisMPGNFatty casts  <response>: Ans. is a i.e., Hyaline castsThe most common involvement of kidney in multiple myeloma is tubulointerstitial disease caused by complications of tumour hypercalcemia, hyperuricemia, obstruction of ureters or therapy irradiation, hyperuricemia, chemotherapy, infections in immunosuppressed individuals.o Factors contributing the damage are :Bence Jones proteinuria and cast nephropathy : This protein is toxic to epithelial cells and they combine with urinary glycoprotein Tamm Harsfall protein to form distinct tubular casts.Amyloidosis. Light-chain nephropathy, Glomerulopathy, tubule-interstitial nephritis. Hyperuricemia, hypercalcemia. Vascular disease. Urinary tract obstruction. 