Monoclonal gammopathy of renal significance: consensus of hematologists and nephrologists of Russia on the establishment of nosology, diagnostic approach and rationale for clone specific treatment

Cover Page

Cite item

Full Text

Abstract

Monoclonal gammopathy of renal significance (MGRS) is a new nosology in modern nephrology and oncohematology. MGRS is defined as kidney injury due to nephrotoxic monoclonal immunoglobulin produced by the B-cell line clone which does not reach the hematological criteria for specific treatment initiation. Monoclonal protein’s pathological effects on kidney parenchyma result in irreversible decline of kidney function till the end stage renal disease that in line with the position of International Consensus of hematologists and nephrologists determinates critical necessity for clone specific treatment in patients with MGRS despite the absence of hematological indications for treatment initiation. Main challenge of MGRS in Russian Federation is an inaccessibility of an in-time diagnostic and appropriate treatment for the great majority of patients due to the following reasons: 1) limited knowledge about the MGRS among hematologists and nephrologists; 2) lack of necessary diagnostic resources in most health-care facilities; 3) lack of approved clinical recommendations and medical economic standards for treatment of this pathological entity. Consensus document comprises the opinion of experts – leading nephrologists and hematologists of Russian Federation – on the problem of MGRS including the incoherence in nosology classification, diagnostics approach and rationale for clone specific treatment. Consensus document is based on conclusions and agreements reached during the conference of leading nephrologists and hematologists of Russia which was held in the framework of symposia “Plasma cell dyscrasias and lymphoproliferative diseases: modern approaches to therapy”, 15–16 of March 2019, Pavlov First Saint Petersburg State Medical University. The present Consensus is intended to define the principal practical steps to resolve the problem of MGRS in Russian Federation that are summarized as final clauses.

About the authors

A. V. Smirnov

Pavlov First Saint Petersburg State Medical University

Email: hrabrovamc@gmail.com
ORCID iD: 0000-0001-7863-9080

д.м.н., проф., дир. НИИ нефрологии, зав. каф. пропедевтики внутренних болезней с клиникой ФГБОУ ВО «Первый СПбГМУ им. акад. И.П. Павлова»

Russian Federation, Saint Petersburg

B. V. Afanasyev

Pavlov First Saint Petersburg State Medical University

Email: hrabrovamc@gmail.com
ORCID iD: 0000-0002-1235-4530

д.м.н., проф., дир. НИИ детской онкологии, гематологии и трансплантологии костного мозга им. Р.М. Горбачевой, зав. каф. гематологии, трансфузиологии, трансплантологии фак-та постдипломного образования ФГБОУ ВО «Первый СПбГМУ им. акад. И.П. Павлова»

Russian Federation, Saint Petersburg

I. V. Poddubnaya

Russian Medical Academy of Continuous Professional Education

Email: hrabrovamc@gmail.com
ORCID iD: 0000-0002-0995-1801

акад. РАН, д.м.н., проф., зав. каф. онкологии ФГБОУ ДПО РМАНПО

Russian Federation, Moscow

V. A. Dobronravov

Pavlov First Saint Petersburg State Medical University

Email: hrabrovamc@gmail.com
ORCID iD: 0000-0002-7179-5520

д.м.н., проф., зам. дир. НИИ нефрологии по научной работе ФГБОУ ВО «Первый СПбГМУ им. акад. И.П. Павлова»

Russian Federation, Saint Petersburg

M. S. Khrabrova

Pavlov First Saint Petersburg State Medical University

Author for correspondence.
Email: hrabrovamc@gmail.com
ORCID iD: 0000-0002-8141-4488

к.м.н., доц. каф. пропедевтики внутренних болезней ФГБОУ ВО «Первый СПбГМУ им. акад. И.П. Павлова»

Russian Federation, Saint Petersburg

E. V. Zakharova

Russian Medical Academy of Continuous Professional Education; Yevdokimov Moscow State University of Medicine and Dentistry; Botkin City Clinical Hospital

Email: hrabrovamc@gmail.com
ORCID iD: 0000-0003-0178-7549

к.м.н., доц. каф. нефрологии ФГБОУ ВО «МГМСУ им. А.И. Евдокимова», доц. каф. нефрологии и диализа ФГБОУ ДПО РМАНПО, зав. отд-нием нефрологии ГБУЗ «ГКБ им. С.П. Боткина»

Russian Federation, Moscow

E. A. Nikitin

Russian Medical Academy of Continuous Professional Education; Botkin City Clinical Hospital

Email: hrabrovamc@gmail.com
ORCID iD: 0000-0002-2490-1263

д.м.н., проф. каф. гематологии и трансфузиологии ФГБОУ ДПО РМАНПО, зав. дневным стационаром гематологии, онкологии и химиотерапии ГБУЗ «ГКБ им. С.П. Боткина»

Russian Federation, Moscow

L. V. Lysenko (Kozlovskaya)

Sechenov First Moscow State Medical University (Sechenov University)

Email: hrabrovamc@gmail.com
ORCID iD: 0000-0002-1166-7308

д.м.н., проф. каф. внутренних, профессиональных болезней и ревматологии Института клинической медицины ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова» (Сеченовский Университет)

Russian Federation, Moscow

I. N. Bobkova

Sechenov First Moscow State Medical University (Sechenov University)

Email: hrabrovamc@gmail.com
ORCID iD: 0000-0002-8007-5680

д.м.н., проф. каф. внутренних, профессиональных болезней и ревматологии Института клинической медицины, научно-исследовательский отд. здоровьесберегающих технологий Научно-технологического парка биомедицины ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова» (Сеченовский Университет)

Russian Federation, Moscow

V. V. Rameev

Sechenov First Moscow State Medical University (Sechenov University)

Email: hrabrovamc@gmail.com
ORCID iD: 0000-0003-4260-0226

к.м.н., доц. каф. внутренних, профессиональных болезней и ревматологии Института клинической медицины ФГАОУ ВО «Первый МГМУ им. И.М. Сеченова» (Сеченовский Университет)

Russian Federation, Moscow

M. M. Batyushin

Rostov State Medical University

Email: hrabrovamc@gmail.com
ORCID iD: 0000-0002-2733-4524

д.м.н., проф. каф. внутренних болезней №2 ФГБОУ ВО РостГМУ

Russian Federation, Rostov-on-Don

I. S. Moiseev

Pavlov First Saint Petersburg State Medical University

Email: hrabrovamc@gmail.com
ORCID iD: 0000-0002-4332-0114

д.м.н., доц. каф. гематологии, трансфузиологии, трансплантологии фак-та постдипломного образования ФГБОУ ВО «Первый СПбГМУ им. акад. И.П. Павлова», зам. дир. НИИ детской онкологии, гематологии и трансплантологии костного мозга им. Р.М. Горбачевой

Russian Federation, Saint Petersburg

E. I. Darskaya

Pavlov First Saint Petersburg State Medical University

Email: hrabrovamc@gmail.com

к.м.н., зав. отд-нием трансплантации костного мозга для взрослых НИИ детской онкологии, гематологии и трансплантологии костного мозга им. Р.М. Горбачевой ФГБОУ ВО «Первый СПбГМУ им. акад. И.П. Павлова»

Russian Federation, Saint Petersburg

O. V. Pirogova

Pavlov First Saint Petersburg State Medical University

Email: hrabrovamc@gmail.com

к.м.н., ст. науч. сотр. НИИ детской онкологии, гематологии и трансплантологии костного мозга им. Р.М. Горбачевой ФГБОУ ВО «Первый СПбГМУ им. акад. И.П. Павлова»

Russian Federation, Saint Petersburg

L. P. Mendeleeva

National Research Center for Hematology

Email: hrabrovamc@gmail.com
ORCID iD: 0000-0002-4966-8146

д.м.н., проф., зам. ген. дир. по научной работе и инновациям ФГБУ «НМИЦ гематологии»

Russian Federation, Moscow

L. S. Biryukova

Russian Medical Academy of Continuous Professional Education; National Research Center for Hematology

Email: hrabrovamc@gmail.com

д.м.н., проф., доц. каф. нефрологии и диализа ФГБОУ ДПО РМАНПО, зав. отд. полиорганной патологии и гемодиализа ФГБУ «НМИЦ гематологии»

Russian Federation, Moscow

References

  1. Leung N, Bridoux F, Hutchison CA, et al. Monoclonal gammopathy of renal significance: when MGUS is no longer undetermined or insignificant. Blood. 2012;120(22):4292-5. doi: 10.1182/blood-2012-07-445304
  2. Leung N, Bridoux F, Batuman V, et al. The evaluation of monoclonal gammopathy of renal significance: a consensus report of the International Kidney and Monoclonal Gammopathy Research Group. Nat Rev Nephrol. 2019;15(1):45-59. doi: 10.1038/s41581-018-0077-4
  3. Козловская Л.В., Рамеев В.В., Когарко И.Н. и др. Поражения почек, ассоциированные с моноклональной гаммапатией неопределенного значения: клинические формы, механизмы развития, подходы к лечению. Клин. медицина. 2016;94(12):892-901 [Kozlovskaya LV, Rameev VV, Kogarko IN, et al. Renal lesions associated with monoclonal gammopathies of undetermined significance: clinical forms, mechanisms of development, approaches to treatment. Klin. meditsina. 2016;94(12):892-901 (In Russ.)]. doi: 10.18821/0023-2149-2016-94-12-892-901
  4. Храброва М.С., Добронравов В.А., Смирнов А.В. Поражения почек, ассоциированные с моноклональными гаммапатиями: одноцентровое исследование. Нефрология. 2018;22(6):38-46 [Khrabrova MS, Dobronravov VA, Smirnov AV. Kidney disease associated with monoclonal gammopathies: single-center study. Nephrology. 2018;22(6):38-46 (In Russ.)]. doi: 10.24884/1561-6274-2018-22-6-38-46
  5. Захарова Е.В., Столяревич Е.С. Особенности нефропатий при лимфопролиферативных и плазмоклеточных заболеваниях (опыт одного центра). Альманах клин. медицины. 2014;30:3-11 [Zakharova EV, Stolyarevich ES. Kidney damage in lymphoproliferative and plasma cell disorders (one center experience). Almanac of Clinical Medicine. 2014;30:3-11 (In Russ.)]. doi: 10.18786/2072-0505-2014-30-3-11
  6. Zakharova EV, Stolyarevich ES. Renal consequences of Lymphoproliferative Disorders and Monoclonal Gammopathy. Urol Nephrol Open Access. 2015;2(4):47-55. doi: 10.15406/unoaj.2015.02.00047
  7. Zand L, Nasr SH, Gertz MA, et al. Clinical and prognostic differences among patients with light chain deposition disease, myeloma cast nephropathy and both. Leuk Lymphoma. 2015;56(12):3357-64. doi: 10.3109/10428194.2015
  8. Lin J, Markowitz GS, Valeri AM, et al. Renal monoclonal immunoglobulin deposition disease: the disease spectrum. J Am Soc Nephrol. 2001;12(7):1482-92.
  9. Nasr SH, Valeri AM, Cornell LD, et al. Renal monoclonal immunoglobulin deposition disease: A report of 64 patients from a single institution. Clin J Am Soc Nephrol. 2012;7:231-9.
  10. Nasr SH, Valeri AM, Cornell LD, et al. Fibrillary glomerulonephritis: A report of 66 cases from a single institution. Clin J Am Soc Nephrol. 2011;6:775-84.
  11. Steiner N, Göbel G, Suchecki P, et al. Monoclonal gammopathy of renal significance (MGRS) increases the risk for progression to multiple myeloma: an observational study of 2935 MGUS patients. Oncotarget. 2017;9(2):2344-56. doi: 10.18632/oncotarget.23412
  12. Kourelis TV, Nasr SH, Dispenzieri A, et al. Outcomes of patients with renal monoclonal immunoglobulin deposition disease. Am J Hematol. 2016;91(11):1123-8. doi: 10.1002/ajh.24528
  13. Cohen C, Royer B, Javaugue V, et al. Bortezomib produces high hematological response rates with prolonged renal survival in monoclonal immunoglobulin deposition disease. Kidney Int. 2015;88:1135-43.
  14. Ziogas DC, Kastritis E, Terpos E, et al. Hematologic and renal improvement of monoclonal immunoglobulin deposition disease after treatment with bortezomib-based regimens. Leuk Lymphoma. 2017;58(8):1832-9. doi: 10.1080/10428194.2016.1267349
  15. Gumber R, Cohen JB, Palmer MB, et al. A clone-directed approach may improve diagnosis and treatment of proliferativeglomerulonephritis with monoclonal immunoglobulin deposits. Kidney Int. 2018;94(1):199-205. doi: 10.1016/j.kint.2018.02.020
  16. Менделеева Л.П., Вотякова О.М., Покровская О.С. и др. Национальные клинические рекомендации по диагностике и лечению множественной миеломы. Гематология и трансфузиология. 2016;61(1, Прил. 2):1-24 [Mendeleeva LP, Votyakova OM, Pokrovskaya OS, et al. National clinical recommendations on diagnosis and treatment of multiple myeloma. Hematology and Transfusiology. Russian Journal (Gematologiya i transfusiologiya). 2016;61(1, Suppl. 2):1-24 (In Russ.)]. doi: 10.18821/0234-5730-2016-61-1
  17. Российские клинические рекомендации по диагностике и лечению лимфопролиферативных заболеваний. Под рук. И.В. Поддубной, В.Г. Савченко. 2016 г. [Russian clinical recommendations on diagnostic and treatment of lymphoproliferative disorders under the leadership of IV Poddubnaya, BG Savchenko. 2016. http://www.hematology.ru/oncohematology/standarts/clinical_guidelines-draft.pdf (In Russ.)].
  18. Dimopoulos MA, Sonneveld P, Leung N, et al. International Myeloma Working Group Recommendations for the Diagnosis and Management of Myeloma-Related Renal Impairment. J Clin Oncol. 2016;34(13):1544-57. doi: 10.1200/JCO.2015.65.0044
  19. Клинические рекомендации по обследованию и лечению больных хроническим лимфолейкозом (2014). Коллектив авторов под рук. В.Г. Савченко, И.В. Поддубной [Clinical recommendations on investigation and treatment of patients with chronic lymphocytic leukemia (2014). Group of authors under the leadership of VG Savchenko, IV Poddubnaya (In Russ.)]. https://blood.ru/documents/clinical%20guidelines/26.%20klinicheskie-rekomendacii-2014-xll.pdf
  20. Swerdlow SH, Campo E, Pileri SA, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127(20):2375-90. doi: 10.1182/blood-2016-01-643569
  21. Kyle RA. Monoclonal gammopathy of undetermined significance. Natural history in 241 cases. Am J Med. 1978;64(5):814-26.
  22. Vardi A, Dagklis A, Scarfò L, et al. Immunogenetics shows that not all MBL are equal: the larger the clone, the more similar to CLL. Blood. 2013;121(22):4521-8. doi: 10.1182/blood-2012-12-471698
  23. Kyle RA, Benson J, Larson D, et al. IgM monoclonal gammopathy of undetermined significance and smoldering Waldenström’s macroglobulinemia. Clin Lymphoma Myeloma. 2009;9(1):17-8. doi: 10.3816/CLM.2009.n.002
  24. Rajkumar SV, Kyle RA, Buadi FK. Advances in the diagnosis, classification, risk stratification, and management of monoclonal gammopathy of undetermined significance: implications for recategorizing disease entities in the presence of evolving scientific evidence. Mayo Clin Proc. 2010;85(10):945-8. doi: 10.4065/mcp.2010.0520
  25. Merlini G, Stone MJ. Dangerous small B-cell clones. Blood. 2006;108(8):2520-30. doi: 10.1182/blood-2006-03-001164
  26. Fermand JP, Bridoux F, Dispenzieri A, et al. Monoclonal gammopathy of clinical significance: a novel concept with therapeutic implications. Blood. 2018;132(14):1478-85. doi: 10.1182/blood-2018-04-839480
  27. Gertz MA. Waldenström macroglobulinemia: 2018 update on diagnosis, risk stratification, and management. Am J Hematol. 2018;1-11. doi: 10.1002/ajh.25292
  28. Fish R, Pinney J, Jain P, et al. The Incidence of major hemorrhagic complications after renal biopsies in patients with monoclonal gammopathies. Clin J Am Soc Nephrol. 2010;5(11):1977-80. doi: 10.2215/CJN.00650110
  29. Matsushita K, van der Velde M, Astor BC, et al. Chronic Kidney Disease Prognosis Consortium. Association of estimated glomerular filtration rate and albuminuria with allcause and cardiovascular mortality in general population cohorts: a collaborative metaanalysis. Lancet. 2010;375(9731):2073-81
  30. Смирнов А.В., Добронравов В.А., Каюков И.Г. Кардио-ренальный континуум: патогенетические основы превентивной нефрологии. Нефрология. 2005;9(3):7-15 [Smirnov AV, Dobronravov VA, Kayukov IG. Сardiorenal continuum, pathogenetical grounds of preventive nephrology. Nephrology. 2005;9(3):7-15 (In Russ.)]. doi: 10.24884/1561-6274-2005-9-3-7-15
  31. Thomas B, Matsushita K, Abate KH, et al. Global Cardiovascular and Renal Outcomes of Reduced GFR. J Am Soc Nephrol. 2017;28(7):2167-79. doi: 10.1681/ASN.2016050562
  32. Van der Velde M, Matsushita K, Coresh J, et al. Chronic Kidney Disease Prognosis Consortium: Lower estimated glomerular filtration rate and higher albuminuria are associated with all-cause and cardiovascular mortality. A collaborative meta-analysis of high-risk population cohorts. Kidney Int. 2011;79:1341-52.
  33. Hui X, Matsushita K, Sang Y, et al. CKD and cardiovascular disease in the Atherosclerosis Risk in Communities (ARIC) study: Interactions with age, sex, and race. Am J Kidney Dis. 2013;62:691-702.
  34. Kyle RA, San-Miguel JF, Mateos MV, Rajkumar SV. Monoclonal gammopathy of undetermined significance and smoldering multiple myeloma. Hematol Oncol Clin North Am. 2014;28(5):775-90. doi: 10.1016/j.hoc.2014.06.005
  35. Buxbaum JN, Hurley ME, Chuba J, Spiro T. Amyloidosis of the AL type. Clinical, morphologic and biochemical aspects of the response to therapy with alkylating agents and prednisone. Am J Med. 1979;67(5):867-78.
  36. Benson MD. Treatment of AL amyloidosis with melphalan, prednisone, and colchicine. Arthritis Rheum. 1986;29(5):683-7.
  37. Vaxman I, Gertz M. Recent Advances in the Diagnosis, Risk Stratification, and Management of Systemic Light-ChainAmyloidosis. Acta Haematol. 2019;141(2):93-106.
  38. Zakharova EV, Stolyarevich ES. Chemotherapy for renal AL amyloidosis: treatment results and outcomes in 49 patients from a single center. Clin Pract. 2016;13(1):11-8.
  39. Fermand JP, Bridoux F, Kyle RA, et al. How I treat monoclonal gammopathy of renal significance (MGRS). Blood. 2013;122(22):3583-90. doi: 10.1182/blood-2013-05-495929
  40. Heilman RL, Velosa JA, Holley KE, et al. Long-term follow-up and response to chemotherapy in patients with light-chain depositiondisease. Am J Kidney Dis. 1992;20(1):34-41.
  41. Cohen C, Royer B, Javaugue V, et al. Bortezomib produces high hematological response rates with prolonged renal survival in monoclonal immunoglobulin deposition disease. Kidney Int. 2015;88:1135-43.
  42. Gavriatopoulou M, Musto P, Caers J, et al. European myeloma network recommendations on diagnosis and management of patients with rare plasma cell dyscrasias. Leukemia. 2018;32(9):1883-98. doi: 10.1038/s41375-018-0209-7
  43. Ziogas DC, Kastritis E, Terpos E, et al. Hematologic and renal improvement of monoclonal immunoglobulin deposition disease after treatment with bortezomib-based regimens. Leuk Lymphoma. 2017;58(8):1832-9. doi: 10.1080/10428194.2016.1267349
  44. Nasr SH, Markowitz GS, Stokes MB, et al. Proliferative glomerulonephritis with monoclonal IgG deposits: a distinct entity mimicking immune-complex glomerulonephritis. Kidney Int. 2004;65(1):85-96.
  45. Nasr SH, Snyder RW, Bhagat G, Markowitz GS. Chronic lymphocytic leukemia and cryoglobulinemic glomerulonephritis. Kidney Int. 2007;71(2):93.
  46. Herrera GA, Joseph L, Gu X, et al. Renal pathologic spectrum in an autopsy series of patients with plasma cell dyscrasia. Arch Pathol Lab Med. 2004;128(8):875-9.
  47. Ciocchini M, Arbelbide J, Musso CG. Monoclonal gammopathy of renal significance (MGRS): the characteristics and significance of a new meta-entity. Int Urol Nephrol. 2017;49(12):2171-5. doi: 10.1007/s11255-017-1594-y
  48. Kanzaki G, Okabayashi Y, Nagahama K, et al. Monoclonal Immunoglobulin Deposition Disease and Related Diseases. J Nippon Med Sch. 2019;86(1):2-9. doi: 10.1272/jnms.JNMS.2019_86-1
  49. Caravaca-Fontán F, Gutiérrez E, Delgado Lillo R, Praga M. Monoclonal gammopathies of renal significance. Nefrologia. 2017;37(5):465-77. doi: 10.1016/j.nefro.2017.03.012
  50. Mehtat Ünlü Ş, Özsan H, Sarıoğlu S, et al. The Scope of Kidney Affection in Monoclonal Gammopathies at All Levels of Clinical Significance. Turk J Haematol. 2017;34(4):282-8. doi: 10.4274/tjh.2017.0197
  51. Sethi S, Rajkumar SV. Monoclonal gammopathy-associated proliferative glomerulonephritis. Mayo Clin Proc. 2013;88(11):1284-93. doi: 10.1016/j.mayocp.2013.08.002
  52. Bridoux F, Leung N, Hutchison CA, et al. Diagnosis of monoclonal gammopathy of renal significance. Kidney Int. 2015;87(4):698-711. doi: 10.1038/ki.2014.408
  53. Available from: https://icd.who.int/browse11/l-m/en#/ http%3a%2f%2fid. who.int%2ficd%2fentity%2f1815409370
  54. Sethi S, Rajkumar SV, D’Agati VD. The Complexity and Heterogeneity of Monoclonal Immunoglobulin-Associated Renal Diseases. J Am Soc Nephrol. 2018;29(7):1810-23. doi: 10.1681/ASN.2017121319
  55. Larsen CP, Messias NC, Walker PD, et al. Membranoproliferative glomerulonephritis with masked monotypic immunoglobulin deposits. Kidney Int. 2015;88(4):867-73. doi: 10.1038/ki.2015.195
  56. Nasr SH, Fidler ME, Said SM. Paraffin Immunofluorescence: A Valuable Ancillary Technique in Renal Pathology. Kidney Int Rep. 2018;3(6):1260-6. doi: 10.1016/j.ekir.2018.07.008
  57. Messias NC, Walker PD, Larsen CP, et al. Paraffin immunofluorescence in the renal pathology laboratory: more than a salvage technique. Mod Pathol. 2015;28(6):854-60. doi: 10.1038/modpathol.2015.1
  58. Alexander MP, Dasari S, Vrana JA, et al. Congophilic Fibrillary Glomerulonephritis: A Case Series. Am J Kidney Dis. 2018;72(3):325-36. doi: 10.1053/j.ajkd.2018.03.017
  59. Nasr SH, Vrana JA, Dasari S, et al. DNAJB9 Is a Specific Immunohistochemical Marker for Fibrillary Glomerulonephritis. Kidney Int Rep. 2017;3(1):56-64. doi: 10.1016/j.ekir.2017.07.017
  60. Herrera GA, Sanders PW, Reddy BV. Ultrastructural immunolabeling: a unique diagnostic tool in monoclonal light chain-related renal diseases. Ultrastruct Pathol. 1994;18:401-16.
  61. Gu X, Herrera GA. Light-chain-mediated acute tubular interstitial nephritis: a poorly recognized pattern of renaldisease in patients with plasma cell dyscrasia. Arch Pathol Lab Med. 2006;130(2):165-9.
  62. Royal V, Quint P, Leblanc M, et al. IgD heavy-chain deposition disease: detection by laser microdissection and mass spectrometry. J Am Soc Nephrol. 2015;26(4):784-90. doi: 10.1681/ASN.2014050481
  63. Leung N, Barnidge DR, Hutchison CA, et al. Laboratory testing in monoclonal gammopathy of renal significance (MGRS). Clin Chem Lab Med. 2016;54(6):929-37. doi: 10.1515/cclm-2015-0994
  64. Rosner MH, Edeani A, Yanagita M, et al. Paraprotein-related kidney disease: diagnosing and treating monoclonal gammopathy of renal significance. Clin J Am Soc Nephrol. 2016;11(12):2280-7. doi: 10.2215/CJN.02920316
  65. Gertz MA. Immunoglobulin light chain amyloidosis: 2016 update on diagnosis, prognosis, and treatment. Am J Hematol. 2016;91(9):947-56. doi: 10.1002/ajh.24433
  66. Pasquali S, Iannuzzella F, Corrandini M, et al. A novel option for reducing free light chains in myeloma kidney: Supra-hemodiafiltration with endogenous reinfusion (HFR). J Nephrol. 2015;28(2):251-4.
  67. Pendón-Ruiz de Mier MV, Alvarez-Lara MA, et al. Effectiveness of haemodiafiltration with ultrafiltrate regeneration in the reduction of light chains in multiple myeloma with renal failure. Nefrologia. 2013;33(6):788-96.
  68. Mene P, Giammarioli E, Fofi C, et al. Serum free light chains removal by HFR hemodiafiltration in patients with multiple myeloma and acute kidney injury: a case series. Kidney Blood Press Res. 2018;43(4):1263-72.
  69. Sayed RH, Wechalekar AD, Gilbertson JA, et al. Natural history and outcome of light chain deposition disease. Blood. 2015;126(26):2805-10. doi: 10.1182/blood-2015-07-658872
  70. Decourt A, Gondouin B, Delaroziere JC, et al. Trends in survival and renal recovery in patients with multiple myeloma or light-chain amyloidosis on chronic dialysis. Clin J Am Soc Nephrol. 2016;11(3):431-41. doi: 10.2215/CJN.06290615
  71. Abudayyeh AA, Lahoti A, Salahudeen AK, et al. Onconephrology: the need and the emergence of a subspecialty in nephrology. Kidney Int. 2014;85(5):1002-4. doi: 10.1038/ki.2014.29
  72. Cohen EP, Krzesinski JM, Launay-Vacher V, Sprangers B. Onco-nephrology: Core Curriculum 2015. Am J Kidney Dis. 2015;66(5):869-83. doi: 10.1053/j.ajkd.2015.04.042
  73. Cosmai L, Porta C, Perazella MA, et al. Opening an onconephrology clinic: recommendations and basic requirements. Nephrol Dial Transplant. 2018;33(9):1503-10. doi: 10.1093/ndt/gfy188
  74. Capasso A, Benigni A, Capitanio U, et al. Summary of the International Conference on Onco-Nephrology: an emerging field in medicine. Kidney Int. 2019. doi: 10.1016/j.kint.2019.04.043

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2020 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 
 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies