PARAKID: Navigating the relation between paraproteins and kidney lesions: A multi-center retrospective observational study.

Publisher: Dustri-Verlag Dr. Karl Feistle Country of Publication: Germany NLM ID: 0364441 Publication Model: Print Cited Medium: Internet ISSN: 0301-0430 (Print) Linking ISSN: 03010430 NLM ISO Abbreviation: Clin Nephrol Subsets: MEDLINE

Original Publication: München-Deisenhofen, Dustri-Verlag Dr. Karl Feistle.

Kidney Diseases*/pathology ; Multiple Myeloma*/complications ; Paraproteinemias*/complications ; Paraproteinemias*/epidemiology; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Immunoglobulins ; Kidney/pathology ; Paraproteins ; Retrospective Studies

Introduction: Monoclonal gammopathy is a heterogeneous group of disorders due to the clonal proliferation of immunoglobulin-producing plasma cells or B lymphocytes. Patients develop kidney disease not only due to malignant transformation but also due to the idiosyncratic properties of the M protein and the host factors. We aim to study the spectrum of kidney diseases in patients with paraproteinemia.
Materials and Methods: A retrospective observational study was performed at three tertiary care centers in Southern India. Kidney biopsies conducted in these three centers were reviewed from June 1, 2020 to November 30, 2022. All biopsies suggestive of monotypic immunoglobulin or light chain restriction were included in the study.
Results: A total of 122 patients were included in the study with an incidence of 2.4%. The mean age was 52.27 ± 13.27 years, and majority (63.1%) were males. AL amyloidosis was most common in the monoclonal gammopathy of renal significance (MGRS) group, and cast nephropathy was most common in the multiple myeloma (MM) group. On histopathology, 83.6% had a single lesion, followed by 14.8% with double lesion, and 1.6% with triple lesion.
Conclusion: Paraproteinemia is associated with a myriad of kidney lesions. MGRS and MM are usually present in the 6 ^th decade of life and beyond, while proliferative glomerulonephritis with monoclonal immunoglobulin deposits is more common in the younger age group. Older age group, high creatinine, hyperuricemia, hyperphosphatemia, presence of more than one lesion on kidney biopsy, and presence of cast nephropathy was significantly associated with the requirement of kidney replacement therapy.

0 (Immunoglobulins)
0 (Paraproteins)

Date Created: 20231023 Date Completed: 20231118 Latest Revision: 20231118

20231215

10.5414/CN111123

37870264