Monoclonal gammopathy of renal significance: From bench to bedside

Abstract Monoclonal gammopathy of renal significance (MGRS) is a unique subset of plasma cell dyscrasias where monoclonal immunoglobulins (IG) cause kidney damage. Unlike monoclonal gammopathy of undetermined significance (MGUS), MGRS can have significant renal pathology and progressive renal damage. Because of the wide range of diseases associated with MGRS, it poses a clinical challenge to accurately diagnose and treat this condition. B-lymphocyte cell clone-directed therapy, along with immunomodulatory agents if started at an early stage, can be beneficial in the management of this condition and preventing its progression to chronic kidney disease requiring renal replacement therapy. Here, we have conducted a literature review of all the data published on this topic of plasma cell disorders, MGRS and MGUS in the last two decades using an electronic database, relevant studies, journal articles, and textbooks to discuss regarding the latest updates on MGRS epidemiology, clinical features and treatment to help the nephrologist and general physicians in identifying and dealing with patients suffering from this condition. Furthermore, renal transplant indications and prognosis in such patients with chronic kidney failure have been discussed in this review article.