Renal Dysfunction in Patients With Direct Infiltration by B-Cell Lymphoma

Area of Science:

• Nephrology
• Hematology
• Oncology

Background:

• B-cell lymphoproliferative disorders frequently involve the kidneys, yet renal manifestations are often under-recognized.
• Kidney biopsy is typically essential for diagnosing renal lesions associated with these disorders, as other methods may fail.

Purpose of the Study:

• To describe the clinical, biological, radiological, and histological characteristics of renal lymphoma.
• To evaluate the diagnostic utility of percutaneous kidney biopsy (PKB) in renal lymphoma.
• To assess the outcomes of renal involvement and treatment in B-cell lymphoproliferative disorders.

Main Methods:

• Retrospective analysis of 34 patients diagnosed with renal lymphoma via PKB between 2004 and 2016.
• Collection of clinical, biological, radiological, and histological data at the time of biopsy.
• Assessment of renal function and syndrome post-hematological treatment.

Main Results:

• Common B-cell lymphomas included Waldenström macroglobulinemia (35.3%) and chronic lymphocytic leukemia (29.5%).
• Renal impairment occurred in 85.3% of patients, with 70% experiencing acute kidney injury; nephrotic syndrome was seen in 11.8%.
• Interstitial infiltrate was the most common histological finding (97.1%), and only 27.6% of patients showed renal response to treatment.

Conclusions:

• Renal involvement in B-cell lymphoproliferative disorders is common and significantly impacts kidney function.
• PKB is the definitive diagnostic method for renal lymphoma, enabling early initiation of treatment.
• Prompt diagnosis and treatment are vital for preserving kidney function in affected patients.