The Monoclonal Gammopathies of Renal Significance

As a heterogeneous group of diseases, monoclonal gammopathy is typical for older age and is characterized by the presence of paraprotein in serum and urine. In addition to damage to the bone marrow, other organs are also affected, whereas in the case of monoclonal gammopathy of renal significance (MGRS), the kidneys are dominant. The clinical presentation of MGRS is diverse depending on the type of renal monoclonal gammopathy. The basis of the diagnosis is the detection of free light chains in the serum, along with electrophoresis and subsequent serum immunofixation. The kappa and lambda serum light chain ratio is evaluated in patients with MGRS within modified reference parameters. A kidney biopsy provides information on the extent of renal parenchymal involvement. The basis of therapy is chemotherapeutics with possible autologous stem cell transplantation to preserve kidney function.