title: Bridging the Divide: An Onco-Nephrologic Approach to the Monoclonal Gammopathies of Renal Significance.
abstract: The monoclonal gammopathies of renal significance (MGRS) are a group of disorders characterized by monoclonal Ig deposition in the kidney, but are not associated with systemic lymphoma or overt multiple myeloma. The prevailing hypothesis is that the pathogenic paraproteins in MGRS are produced by underlying B cell or plasma cell clones. However, in the MGRS literature, the yield of detecting a clone has been variable, and progression to ESRD is common. Here, we present an "onco-nephrologic" approach to the MGRS disorders by highlighting recent advances in lymphoma and multiple myeloma that can be used in the evaluation and management of these patients.
authors.affiliation: Division of Nephrology and.
authors.forename: Jonathan J
authors.initials: JJ
authors.lastname: Hogan
authors.affiliation: Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Brendan M
authors.initials: BM
authors.lastname: Weiss
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000069461:Bendamustine Hydrochloride / Q000008:administration & dosage; D000069286:Bortezomib / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D006801:Humans; D007136:Immunoglobulins / Q000378:metabolism; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007674:Kidney Diseases / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D000077269:Lenalidomide; D008558:Melphalan / Q000008:administration & dosage; D009842:Oligopeptides / Q000008:administration & dosage; D010265:Paraproteinemias / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D015649:Pentostatin / Q000008:administration & dosage; D000069283:Rituximab / Q000008:administration & dosage; D013792:Thalidomide / Q000031:analogs & derivatives / Q000627:therapeutic use; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives
chemical_list: D007136:Immunoglobulins; D007166:Immunosuppressive Agents; D009842:Oligopeptides; D015649:Pentostatin; D000069283:Rituximab; D013792:Thalidomide; D000069286:Bortezomib; C524865:carfilzomib; D003907:Dexamethasone; D003520:Cyclophosphamide; D000069461:Bendamustine Hydrochloride; D000077269:Lenalidomide; D014740:Vidarabine; C024352:fludarabine; D008558:Melphalan
keywords: B-Lymphocytes; Chronic; Humans; Kidney Failure; Lymphoma; Myeloma Proteins; Paraproteinemias; Paraproteins; Plasma Cells; glomerular disease; kidney; multiple myeloma; multiple myeloma M-proteins; proteinuria