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Researchers found that older individuals with monoclonal gammopathy and kidney issues had a higher risk of monoclonal gammopathy of renal significance (MGRS), with elevated urinary protein levels (>1.5 g/d) and abnormal free light-chain ratios identified as key predictors.

The following is a summary of “Systematic review and meta-analysis of the clinical features of MGRS,” published in the January 2024 issue of Nephrology by Du et al.

Researchers conducted a retrospective meta-analysis study to characterize monoclonal gammopathy of renal significance (MGRS) patients and pinpoint factors predicting its occurrence.

They conducted a systematic search for cohort or case-control studies on MGRS clinicopathological features (December 2022) across PubMed, Cochrane Library, Web of Science, Scopus, and Embase databases. Two researchers identified studies meeting the inclusion criteria. Pooled estimates of weighted mean difference (WMD) and OR for risk factors were obtained using fixed- or random-effects models in the univariate analysis. In multivariate analysis, independent risk factors’ ORs were pooled from each study’s original estimates.

The results showed six studies with MGRS, age showed a statistically significant increase (WMD = 1.78, 95% CI 0.21–3.35), while hypertension (OR = 0.54, 95% CI 0.4–0.73) and diabetes (OR = 0.42, 95% CI 0.29–0.59) demonstrated significant decreases. Albumin exhibited a decline (WMD = −0.26, 95% CI −0.38–−0.14), and urinary protein levels (WMD = 0.76, 95%CI 0.31–1.2) and urinary protein ≥ 1.5 g/d (OR = 1.98, 95% CI 1.46–2.68) were elevated. Lambda-chain value increased (WMD = 29.02, 95% CI 16.55–41.49), and abnormal free light-chain ratio (OR = 4.16, 95%CI 1.65–10.47), bone marrow puncture rate (OR = 5.11, 95% CI 1.31–19.95), and abnormal bone marrow outcome rate (OR = 9.63, 95%CI 1.98–46.88) were all notably significant. In multivariate analysis, predictors of MGRS were associated with urinary protein ≥ 1.5 g/d (OR = 2.80, 95%CI 1.53–5.15) and abnormal free light-chain ratio (OR = 6.98, 95%CI 4.10–11.91).

They concluded that older MGRS patients with higher urinary protein (>1.5 g/d) and abnormal light chains stood out among those with monoclonal gammopathy and kidney issues.

Source: bmcnephrol.biomedcentral.com/articles/10.1186/s12882-024-03458-5