Kidney Biopsy in Patients With Monoclonal Gammopathy: A Multicenter Retrospective Cohort Study.
Kidney Biopsy in Patients With Monoclonal Gammopathy: A Multicenter Retrospective Cohort Study.
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单克隆丙种球蛋白病患者的肾活检：多中心回顾性队列研究
DOI：
10.3389/fmed.2021.687149
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发表时间：
2021
影响因子：
3.9
通讯作者：
Wang G
中科院分区：
文献类型：
--
作者：
Nie S;Wang M;Wan Q;Kong Y;Ou J;Jia N;Zhang X;Luo F;Liu X;Wang L;Cao Y;Chen R;Zhao M;Chan DYL;Wang G
目的：分析单克隆丙种球蛋白病（MG）合并肾损伤患者的临床特点和肾脏病理表现。方法：这是一项在中国四家三级医院进行的多中心回顾性队列研究。研究人群包括2013年1月1日至2020年12月31日期间入院的重症肌无力患者。所有患者的住院记录、实验室数据和肾活检报告均通过医院电子信息系统收集。研究结果包括肾病进展和肾活检后主要出血并发症。结果：我们确定了 1,164 名 MG 患者，其中 782 名 (67.2%) 患有潜在的肾损伤。在 101 名接受肾活检的患者中，16 名患有恶性肿瘤。淀粉样肾病是最常见的发现（n = 34，33.7%），其次是膜性肾病（n = 18，17.8%）和膜增殖性肾炎（n = 8，7.9%）。在 85 名接受肾活检的非恶性血液病患者中，43 名患者患有肾意义型 MG (MGRS) 相关病变，42 名患者患有 MG 无关病变。肾损伤患者的肾脏疾病进展风险高于无肾损伤患者。结论：在伴有肾损伤的 MG 患者中，只有 12.9% 的患者接受了肾活检，其中超过 40% 的患者存在与 MG 无关的病变。肾活检是安全且必要的，可以最大程度地提高临床疑似肾意义型 MG (MGRS) 患者正确诊断的可能性。
Objectives: To analyze the clinical characteristics and renal pathological manifestations of patients with monoclonal gammopathy (MG) and kidney injury. Methods: This was a multicenter retrospective cohort study conducted at four tertiary hospitals in China. The study population comprised patients with MG admitted from January 1 2013 to December 31 2020. Hospitalization records, laboratory data, and kidney biopsy reports of all patients were collected from the electronic hospital information systems. The study outcomes included kidney disease progression and major hemorrhagic complications after kidney biopsy. Results: We identified 1,164 patients with MG, 782 (67.2%) of whom had underlying kidney injury. Of 101 patients who underwent kidney biopsy, 16 had malignant neoplasms. Amyloid nephropathy was the most common finding (n = 34, 33.7%), followed by membranous nephropathy (n = 18, 17.8%) and membranoproliferative nephritis (n = 8, 7.9%). Among 85 patients with non-malignant hematologic conditions who underwent kidney biopsy, 43 had MG of renal significance (MGRS) related lesions and 42 had MG-unrelated lesions. The risk of kidney disease progression was higher in patients with kidney injury than in patients without kidney injury. Conclusion: Among patients with MG and kidney injury, only 12.9% underwent kidney biopsy and more than 40% of these patients had MG-unrelated lesions. A kidney biopsy is safe and essential to maximize the possibility of correct diagnosis for patients with clinically suspected MG of renal significance (MGRS).
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影响因子：
168.9
作者：
Roellig, Christoph;Knop, Stefan;Bornhaeuser, Martin
通讯作者：
Bornhaeuser, Martin
影响因子：
20.3
作者：
Fermand, Jean-Paul;Bridoux, Frank;Merlini, Giampaolo
通讯作者：
Merlini, Giampaolo
影响因子：
13.2
作者：
Soares, Sandra M.;Fervenza, Fernando C.;Leung, Nelson
通讯作者：
Leung, Nelson
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影响因子：
8.9
作者：
Chaudhry HM;Mauermann ML;Rajkumar SV
通讯作者：
Rajkumar SV
影响因子：
20.3
作者：
Leung, Nelson;Bridoux, Frank;Kyle, Robert A.
通讯作者：
Kyle, Robert A.