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
- Authors: Smirnov A.V.1, Afanasyev B.V.1, Poddubnaya I.V.2, Dobronravov V.A.1, Khrabrova M.S.1, Zakharova E.V.2,3,4, Nikitin E.A.2,4, Lysenko (Kozlovskaya) L.V.5, Bobkova I.N.5, Rameev V.V.5, Batyushin M.M.6, Moiseev I.S.1, Darskaya E.I.1, Pirogova O.V.1, Mendeleeva L.P.7, Biryukova L.S.2,7
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Affiliations:
- Pavlov First Saint Petersburg State Medical University
- Russian Medical Academy of Continuous Professional Education
- Yevdokimov Moscow State University of Medicine and Dentistry
- Botkin City Clinical Hospital
- Sechenov First Moscow State Medical University (Sechenov University)
- Rostov State Medical University
- National Research Center for Hematology
- Issue: Vol 92, No 7 (2020)
- Pages: 10-22
- Section: Consensuns
- URL: https://journals.rcsi.science/0040-3660/article/view/43118
- DOI: https://doi.org/10.26442/00403660.2020.07.000659
- ID: 43118
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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.
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##article.viewOnOriginalSite##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 PetersburgB. 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 PetersburgI. 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, MoscowV. 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 PetersburgM. 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 PetersburgE. 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, MoscowE. 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, MoscowL. 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, MoscowI. 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, MoscowV. 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, MoscowM. 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-DonI. 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 PetersburgE. 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 PetersburgO. 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 PetersburgL. 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, MoscowL. 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, MoscowReferences
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