Decrease in renal function as signified by serum creatinine (Scr) elevation of > 25% was associated with inferior overall survival (OS) in AL patients. However, the OS was significantly affected only in patients who did not achieved >85% reduction of proteinuria (p = 0.006). In patients with > 85% reduction of proteinuria, elevation of Scr of > 25% did not affect OS (p = 0.78).