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

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.

Automated summary

Monoclonal gammopathy of renal significance (MGRS) refers to a group of kidney disorders caused by a monoclonal immunoglobulin (MIg) that does not meet current hematologic criteria for therapy. MGRS-associated kidney diseases are diverse and can lead to end stage kidney disease (ESKD). Diagnosis is made through kidney biopsy and treatment should be coordinated between hematologists and nephrologists based on the type of MGRS, degree of kidney function impairment, and risk of progression to ESKD.