Abstract:

Monoclonal gammopathy of renal significance (MGRS) is defined by the causal relationship between a small Bcell clone and renal disease, usually through deposition of the secreted monoclonal immunoglobulin (MIg) or a fragment of MIg. In the past, for the hematologic disorder in patients with MGRS was consistent with monoclonal gammopathy of undetermined significance (MGUS) and the treatment was not recommended for MGUS, therapy for patients with MGRS was commonly withheld. However, the facts that preservation and restoration of kidney function are possible with successful treatment targeting the responsible clone, that the persistence of the monoclonal gammopathy is associated with high rates of recurrence after kidney transplantation in patients with end stage renal disease, and that achievement of hematologic complete response has been shown to prevent recurrence after kidney transplantation.Those data demonstrate that MGRS is no longer undetermined and necessary to achieve appropriate therapy. Here, we summarize progression of diagnosis and treatment of MGRS.