Effect of monoclonal gammopathy in the progression of acute kidney injury and chronic kidney disease: a retrospective observational study.

Autor: Mitani K; Centre of Medical Information Science, Kochi Medical School, Kochi University, Kohasu, Oko-Cho, Nankoku, Kochi, 783-8505, Japan., Horino T; Department of Endocrinology, Metabolism, and Nephrology, Kochi Medical School, Kochi University, Kohasu, Oko-Cho, Nankoku, Kochi, 783-8505, Japan. horinott@yahoo.co.jp., Terada Y; Department of Endocrinology, Metabolism, and Nephrology, Kochi Medical School, Kochi University, Kohasu, Oko-Cho, Nankoku, Kochi, 783-8505, Japan., Okuhara Y; Centre of Medical Information Science, Kochi Medical School, Kochi University, Kohasu, Oko-Cho, Nankoku, Kochi, 783-8505, Japan., Hatakeyama Y; Centre of Medical Information Science, Kochi Medical School, Kochi University, Kohasu, Oko-Cho, Nankoku, Kochi, 783-8505, Japan.
Jazyk: angličtina
Zdroj: Clinical and experimental nephrology [Clin Exp Nephrol] 2024 Nov 23. Date of Electronic Publication: 2024 Nov 23.
DOI: 10.1007/s10157-024-02571-x
Abstrakt: Background: The involvement of monoclonal immunoglobulin (MIg) in renal damage in patients with haematological disorders and renal biopsy-proven monoclonal gammopathy of renal significance is well established. However, no epidemiological studies have been conducted on the effects of MIg on renal function in other patients. We aimed to evaluate the renal prognosis of MIg-positive patients and the effects of MIg on renal function.
Methods: This retrospective observational study was performed using clinical data from all outpatients and inpatients who underwent MIg measurements at the time of enrolment at Kochi Medical School Hospital between 1 January 2017 and 31 December 2021. The primary outcomes were the occurrence of acute kidney injury (AKI) and a decline of > 30% in the estimated glomerular filtration rate (eGFR).
Results: Among the 1362 patients, 750 were included in our cohort. The number of MIg-positive and MIg-negative patients was 119 (15.9%) and 631 (84.1%), respectively. In addition, the MIg-positive patients were significantly older than the MIg-negative patients. The survival probability of the MIg-positive group was significantly lower than that of the MIg-negative group during the 2 year observation period. The risk factors for the primary endpoint were positive MIg, female sex, lower eGFR, and lower albumin level.
Conclusions: Our study showed that the presence of MIg was an independent risk factor for renal damage. Therefore, we suggest that MIg-positive patients require careful follow-up of their renal function, even in the absence of a clear underlying disease, such as multiple myeloma.
Competing Interests: Declarations. Conflict of interest: The authors have declared that no conflict of interest exists. Informed consent: Informed consent was obtained from all the individual participants included in the study. Data were obtained from patients who completed a general consent form based on an opt-out policy at Kochi Medical School Hospital. Research involving human participants: All the procedures were performed in accordance with the ethical standards of the Institutional Research Committee of Kochi Medical School Hospital (IRB approval number: 23-15) and the 1964 Helsinki Declaration and its later amendments.
(© 2024. The Author(s), under exclusive licence to Japanese Society of Nephrology.)
Databáze: MEDLINE
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