[Renal involvement in monoclonal gammopathies]

Area of Science:

• Nephrology
• Hematology
• Oncology

Context:

• Renal complications are common in monoclonal gammapathies (MG), particularly multiple myeloma (MM).
• Bence-Jones protein is the primary nephrotoxic factor, damaging renal parenchyma through various mechanisms.
• Clinical manifestations include proteinuria, tubular dysfunction, and reduced kidney filtration.

Purpose:

• To explore the pathogenesis and clinical manifestations of renal affections in monoclonal gammapathies.
• To evaluate the impact of modern therapeutic approaches on renal function recovery.

Summary:

• Monoclonal gammapathies (MG) frequently lead to renal affections, with Bence-Jones protein playing a key pathogenetic role.
• Paraproteins interfere with tubular function, precipitate within renal tubules, and form deposits in renal tissue.
• While 5-10% of patients develop renal failure, contemporary treatments combining hematologic and symptomatic care, including extracorporeal therapies, improve outcomes.

Impact:

• Understanding these mechanisms aids in diagnosing and managing kidney complications in MG and MM patients.
• Therapeutic strategies focusing on the underlying disease and supportive care can significantly improve renal function and prognosis.