Clinicopathological characteristics of patients with paraproteinemia and renal damage
Abstract Background This study aimed to analyze the clinicopathological characteristics of patients with paraproteinemia and renal damage. Methods Ninety-six patients from 2014 to 2018 with paraproteinemia and renal damage were enrolled and the clinical data, renal pathology, treatment and prognosis...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-07-01
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| Series: | European Journal of Medical Research |
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| Online Access: | https://doi.org/10.1186/s40001-021-00538-2 |
| _version_ | 1818456526077034496 |
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| author | Xuanli Tang Feng Wan Jin Yu Xiaohong Li Ruchun Yang Bin Zhu |
| author_facet | Xuanli Tang Feng Wan Jin Yu Xiaohong Li Ruchun Yang Bin Zhu |
| author_sort | Xuanli Tang |
| collection | DOAJ |
| description | Abstract Background This study aimed to analyze the clinicopathological characteristics of patients with paraproteinemia and renal damage. Methods Ninety-six patients from 2014 to 2018 with paraproteinemia and renal damage were enrolled and the clinical data, renal pathology, treatment and prognosis data were collected. Results A total of 96 patients (54 male and 42 female), accounting for 2.7% of all renal biopsies, were enrolled in this study. Among them, 42 were monoclonal gammopathy of renal significance (MGRS), 21 were renal monotypic immunoglobulin alone (renal monoIg), and 19 were monoclonal gammopathy of undetermined significance (MGUS). Individuals with multiple myeloma (MM) accounted for the fewest number of patients (n = 14). In the MGRS group, the main diseases were amyloidosis (n = 25) and cryoglobulinemic glomerulonephritis (n = 7), while in the MM group, the main diseases were cast nephropathy (n = 9) and light chain deposit disease (n = 3). In the MGUS group, it was mainly IgA nephropathy (IgAN, n = 10) and idiopathic membranous nephropathy (n = 5); while in the renal monoIg group, most of the cases were IgAN (n = 19). Chemotherapy was mainly administered to patients in the MM group, while immunosuppression therapy was mostly administered to patients in the renal monoIg group. Most patients with renal monoIg exhibited a major response, followed by the patients with MGUS and MGRS, while most of the patients with MM had a partial response but none had a major response. Approximately more than half (57.1%) of the patients with MM progressed to end-stage renal disease (ESRD), followed by MGRS (33.3%); however, the mortality rate was low in both the MGRS and MM groups. The survival analysis reviewed that serum creatinine, hemoglobin levels, and the serum κ/λ ratio were independent risk factors for ESRD in patients with MGRS. Conclusions The clinicopathological changes in patients with MGRS were between those in patients with MM and MGUS. The treatment for MGRS and MM was more intensive, and the overall mortality rate was low. Both MGUS and renal monoIg alone exhibited slighter clinicopathological features than MGRS and MM, and the treatment was focused mostly on primary renal diseases. |
| first_indexed | 2024-12-14T22:28:04Z |
| format | Article |
| id | doaj.art-5e9781307d8c4647a1d46bc3bdf96d6d |
| institution | Directory Open Access Journal |
| issn | 2047-783X |
| language | English |
| last_indexed | 2024-12-14T22:28:04Z |
| publishDate | 2021-07-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj.art-5e9781307d8c4647a1d46bc3bdf96d6d2022-12-21T22:45:18ZengBMCEuropean Journal of Medical Research2047-783X2021-07-0126111110.1186/s40001-021-00538-2Clinicopathological characteristics of patients with paraproteinemia and renal damageXuanli Tang0Feng Wan1Jin Yu2Xiaohong Li3Ruchun Yang4Bin Zhu5Department of Nephrology, Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical UniversityDepartment of Nephrology, Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical UniversityDepartment of Nephrology, Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical UniversityDepartment of Nephrology, Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical UniversityDepartment of Nephrology, Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical UniversityDepartment of Nephrology, Key Laboratory of Kidney Disease Prevention and Control Technology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical UniversityAbstract Background This study aimed to analyze the clinicopathological characteristics of patients with paraproteinemia and renal damage. Methods Ninety-six patients from 2014 to 2018 with paraproteinemia and renal damage were enrolled and the clinical data, renal pathology, treatment and prognosis data were collected. Results A total of 96 patients (54 male and 42 female), accounting for 2.7% of all renal biopsies, were enrolled in this study. Among them, 42 were monoclonal gammopathy of renal significance (MGRS), 21 were renal monotypic immunoglobulin alone (renal monoIg), and 19 were monoclonal gammopathy of undetermined significance (MGUS). Individuals with multiple myeloma (MM) accounted for the fewest number of patients (n = 14). In the MGRS group, the main diseases were amyloidosis (n = 25) and cryoglobulinemic glomerulonephritis (n = 7), while in the MM group, the main diseases were cast nephropathy (n = 9) and light chain deposit disease (n = 3). In the MGUS group, it was mainly IgA nephropathy (IgAN, n = 10) and idiopathic membranous nephropathy (n = 5); while in the renal monoIg group, most of the cases were IgAN (n = 19). Chemotherapy was mainly administered to patients in the MM group, while immunosuppression therapy was mostly administered to patients in the renal monoIg group. Most patients with renal monoIg exhibited a major response, followed by the patients with MGUS and MGRS, while most of the patients with MM had a partial response but none had a major response. Approximately more than half (57.1%) of the patients with MM progressed to end-stage renal disease (ESRD), followed by MGRS (33.3%); however, the mortality rate was low in both the MGRS and MM groups. The survival analysis reviewed that serum creatinine, hemoglobin levels, and the serum κ/λ ratio were independent risk factors for ESRD in patients with MGRS. Conclusions The clinicopathological changes in patients with MGRS were between those in patients with MM and MGUS. The treatment for MGRS and MM was more intensive, and the overall mortality rate was low. Both MGUS and renal monoIg alone exhibited slighter clinicopathological features than MGRS and MM, and the treatment was focused mostly on primary renal diseases.https://doi.org/10.1186/s40001-021-00538-2ParaproteinemiaMonoclonal gammopathy of renal significanceMultiple myelomaMonoclonal gammopathy of undetermined significanceRenal monotypic immunoglobulin |
| spellingShingle | Xuanli Tang Feng Wan Jin Yu Xiaohong Li Ruchun Yang Bin Zhu Clinicopathological characteristics of patients with paraproteinemia and renal damage European Journal of Medical Research Paraproteinemia Monoclonal gammopathy of renal significance Multiple myeloma Monoclonal gammopathy of undetermined significance Renal monotypic immunoglobulin |
| title | Clinicopathological characteristics of patients with paraproteinemia and renal damage |
| title_full | Clinicopathological characteristics of patients with paraproteinemia and renal damage |
| title_fullStr | Clinicopathological characteristics of patients with paraproteinemia and renal damage |
| title_full_unstemmed | Clinicopathological characteristics of patients with paraproteinemia and renal damage |
| title_short | Clinicopathological characteristics of patients with paraproteinemia and renal damage |
| title_sort | clinicopathological characteristics of patients with paraproteinemia and renal damage |
| topic | Paraproteinemia Monoclonal gammopathy of renal significance Multiple myeloma Monoclonal gammopathy of undetermined significance Renal monotypic immunoglobulin |
| url | https://doi.org/10.1186/s40001-021-00538-2 |
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