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Master Thesis

Gammapathie monoclonale en néphrologie : prévalence de l’atteinte rénale et facteurs prédictifs du résultat histologique

Abstract : Inroduction: the prevalence of monoclonal gammopathy (MG) and kidney disease increases with age. The nephrologist is often confronted with patients who have both circulating MG and kidney disease but do not know if these two events are related to each other. Methods : all patients who underwent renal biopsy in our center between July 2007 and July 2018 and had a GM were included to study the prevalence and identify predictors of nephropathy secondary to monoclonal gammopathy (NSMG). Results : of 2772 biopsied patients, 330 (12%) were included in the study. Nearly 80% of them had renal failure (GFR <60ml/min, 15% of which was in stage V) and nearly 50% had nephrotic syndrome. Hematologic malignancy was associated in 25% of cases; 93 patients (28%) had NSMG at the renal biopsy. They had higher renal impairment and higher proteinuria compared to non-NSMG patients. The markers most commonly associated with the presence of NGMG were positive Bence Jones proteinuria (PBJ), abnormal Kappa/Lambda ratio, and electrophoresis peaks greater than 1.5 g/l. However, alone or associated, none had sufficient power to formally predict the outcome of the biopsy. Conclusion: one-third of patients with MG in nephrology have related renal disease. A positive PBJ and an abnormal Kappa/Lambda ratio are frequently associated with the presence of a NSMG but the biopsy, beyond its diagnostic and prognostic interest, remains the most discriminating evaluation.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03187932
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Submitted on : Thursday, April 1, 2021 - 3:07:29 PM
Last modification on : Friday, September 3, 2021 - 3:32:56 AM

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Arthur Roux. Gammapathie monoclonale en néphrologie : prévalence de l’atteinte rénale et facteurs prédictifs du résultat histologique. Médecine humaine et pathologie. 2019. ⟨dumas-03187932⟩

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