Monoclonal gammopathy of renal significance: Multidisciplinary approach to diagnosis and treatment

Sabine Karam; Mohammad Haidous; Iman Abou Dalle; Amélie Dendooven; Nour Moukalled; Amaryllis Van Craenenbroeck; Ali Bazarbachi; Ben Sprangers

doi:10.1016/j.critrevonc.2023.103926

Monoclonal gammopathy of renal significance: Multidisciplinary approach to diagnosis and treatment

Crit Rev Oncol Hematol. 2023 Mar:183:103926. doi: 10.1016/j.critrevonc.2023.103926. Epub 2023 Feb 2.

Authors

Sabine Karam¹, Mohammad Haidous², Iman Abou Dalle³, Amélie Dendooven⁴, Nour Moukalled³, Amaryllis Van Craenenbroeck⁵, Ali Bazarbachi⁶, Ben Sprangers⁷

Affiliations

¹ Division of Nephrology and Hypertension, University of Minnesota, Minneapolis, MN, United States.
² Department of Medicine, Saint Vincent Charity Medical Center, Cleveland, OH, United States.
³ Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
⁴ Department of Pathology, University Hospital Ghent, Ghent, Belgium.
⁵ Department of Microbiology, Immunology and Transplantation, Laboratory of Nephrology, KU Leuven, Leuven, Belgium; Division of Nephrology, University Hospitals Leuven, Leuven, Belgium.
⁶ Bone Marrow Transplantation Program, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon; Department of Anatomy, Cell Biology and Physiological Sciences, American University of Beirut Medical Center, Beirut, Lebanon.
⁷ Biomedical Research Institute, Department of Immunology and Infection, University Hasselt, Diepenbeek, Belgium; Department of Nephrology, Ziekenhuis Oost-Limburg, Genk, Belgium. Electronic address: ben.sprangers@zol.be.

PMID: 36736510
DOI: 10.1016/j.critrevonc.2023.103926

Abstract

Monoclonal gammopathy of renal significance (MGRS) is a hemato-nephrological term referring to a heterogeneous group of kidney disorders characterized by direct or indirect kidney injury caused by a monoclonal immunoglobulin (MIg) produced by a B cell or plasma cell clone that does not meet current hematologic criteria for therapy. MGRS-associated kidney diseases are diverse and can result in the development of end stage kidney disease (ESKD). The diagnosis is typically made by nephrologists through a kidney biopsy. Many distinct pathologies have been identified and they are classified based on the site or composition of the deposited Mig, or according to histological and ultrastructural findings. Therapy is directed towards the identified underlying clonal population and treatment decisions should be coordinated between hematologists and nephrologists in a multidisciplinary fashion, depend on the type of MGRS, the degree of kidney function impairment and the risk of progression to ESKD.

Keywords: Chemotherapy; MGRS; MGUS; Monoclonal protein.

Publication types

Review

MeSH terms

Humans
Kidney / pathology
Kidney Diseases*
Kidney Failure, Chronic*
Monoclonal Gammopathy of Undetermined Significance* / complications
Monoclonal Gammopathy of Undetermined Significance* / pathology
Paraproteinemias* / pathology