MGUS and Risk of Chronic Kidney Disease: Results of the Population-Based iStopMM Study

Dr. Thorir Einarsson Long, University of Iceland, presents an abstract to compare the prevalence of chronic kidney disease in individuals with and without monoclonal gammopathy of undetermined significance in a large, prospective, screened, population-based cohort.
Background:
Monoclonal gammopathy of undetermined significance (MGUS) and chronic kidney disease (CKD) are common conditions. When monoclonal gammopathy causes CKD it is referred to as monoclonal gammopathy of renal significance (MGRS) and a kidney biopsy is required to confirm the diagnosis. Because of this, some have speculated that MGRS may be severely underdiagnosed and have recommended considering a kidney biopsy in all individuals with MGUS who have microscopic hematuria, proteinuria, or declining estimated glomerular filtration rate (eGFR) of less than 60 mL/min/1.73m2. If MGRS were more common than previously thought, the prevalence of CKD in persons with MGUS would be expected to be higher than persons without MGUS. We aimed to compare the prevalence of CKD in individuals with and without MGUS in a large, prospective, screened, population-based cohort. Furthermore, we aimed to assess possible association between M protein concentration and kidney function.
Conclusions:
In this nationwide prospective population-based screening study of nearly 70,000 individuals, we found no association between MGUS and CKD, regardless of whether CKD was defined based on eGFR, urinary findings, or both. Furthermore, we found no association between M protein concentration and eGFR or severity of albuminuria. We conclude that in the absence of multiple myeloma, the results of SPEP, IFE, and serum FLC measurements are of little value in the evaluation of CKD. Furthermore, our results are not consistent with substantial underdiagnosis of MGRS.
Authors:
Thorir Einarsson Long, MD, PhD, Elias Eythorsson, MD, PhD, Sæmundur Rögnvaldsson, MD, Olafur Indridason, MD, MHS, Runolfur Palsson, MD, Sigrún Thorsteinsdóttir, MD, PhD, Ingigerdur S Sverrisdottir, MD, Thor Aspelund, PhD, Brynjar Vidarsson, MD, Páll Torfi Onundarson, MD, Bjarni Agnarsson, MD, Margrét Sigurdardóttir, MD, Ingunn Thorsteinsdottir, MD, Ísleifur Ólafsson, MD, PhD, Asdis Rosa Thordardottir, Asbjorn Jonsson, MD, Gauti Kjartan Gislason, MSc, Andri Olafsson, Hlif Steingrimsdottir, MD, Malin Hultcrantz, MD, PhD, Brian G.M. Durie, MD, Stephen Harding, PhD, Ola Landgren, MD, Thorvardur Jon Love, MD, PhD and Sigurdur Y Kristinsson, MD, PhD
ASH Abstract #4541: ash.confex.com/ash/2022/webpr...
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[@tbone4646]

Good news for patients and good presentation.