Paraneoplastic glomerulopathy associated with solid tumors: A review

The recognition that malignancies may be accompanied by glomerular disease dates back to the 1920s. Various neoplasms have since been linked to a broad spectrum of glomerular lesions. These include solid tumors, such as lung and gastrointestinal tract cancers, as well as hematologic malignancies. Together, these observations suggest underlying pathophysiologic connections between the glomerulopathy and malignancy. However, how neoplasms trigger glomerular injury is still largely unclear. This review summarizes current knowledge of paraneoplastic glomerular diseases in patients with solid tumors, focusing on recent advances in epidemiology, pathophysiology, diagnostic biomarkers, clinical features, and therapeutic approaches. Furthermore, we propose a mechanistic framework that organizes the diverse histological patterns into four major pathogenic pathways: immune complex and antibody-mediated deposition, T-cell and cytokine-mediated podocytopathy, growth factor-induced glomerular hyperpermeability, and precursor protein deposition. This classification provides both conceptual clarity and clinical utility for managing this underrecognized condition.