ArticleNephron2026
Real-World Outcomes of Patients with Monoclonal Gammopathy of Renal Significance.
Article in Nephron, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
<p>Background: Monoclonal gammopathy of renal significance (MGRS) is a rare group of renal disorders caused by monoclonal immunoglobulins from non-malignant B-cell or plasma cell clones, with distinct amyloid (MGRS-A) and non-amyloid (MGRS-NA) subtypes. Although these are often grouped together, whether they share similar clinical phenotypes and outcomes is uncertain. We therefore examined similarities and differences between these subtypes in a contemporary real-world cohort.
methodsWe performed a single-centre retrospective evaluation of 17 biopsy-confirmed MGRS patients (10 MGRS-A, 7 MGRS-NA). Baseline parameters, treatment exposure, renal and haematologic responses, survival, and relapse were analysed descriptively with exploratory subgroup comparisons.
resultsMGRS-NA patients presented with significantly worse baseline renal function (median estimated glomerular filtration rate 18.0 mL/min/1.73 m2 vs. 49.0 mL/min/1.73 m2 in MGRS-A, p < 0.05) and progressed faster to dialysis (p < 0.01). Haematologic responses (≥VGPR) were achieved in 57.1% of MGRS-NA and 50% of MGRS-A patients, but these did not significantly correlate with renal improvement. Survival was similar between groups, with deaths in 28.6% of MGRS-NA and 20% of MGRS-A. Relapse occurred in 47.1% of patients, with median times of 51 months in MGRS-NA and 69 months in MGRS-A. Treatment, primarily bortezomib-based chemotherapy, was associated with toxicities (94.1%), yet renal responses remained limited.
conclusionThe findings highlight the poor prognosis and rapid renal decline in MGRS-NA. We highlight the need for early diagnosis and an integrated renal-haematologic service to improve outcomes in this rare population. </p>.
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