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Monoclonal gammopathy of renal significance are a group of kidney disorders that present with kidney damage due to nephrotoxic monoclonal immunoglobulins secreted by clonal plasma cells or B cells. By definition, people with MGRS do not meet criteria for multiple myeloma or other hematologic malignancies. The term MGRS was introduced in 2012 by the International Kidney and Monoclonal Gammopathy Research Group. MGRS is associated with monoclonal gammopathy of undetermined significance. People with MGUS have a monoclonal gammopathy but does not meet the criteria for the clonal burden nor the presence of end organ damage seen in hematologic malignancies. In a population based study based on the NHANES III health survey; 6% of patients with MGUS were subsequently classified as having MGRS. The prevalence and incidence of MGRS in the general population or in specific populations is not known but it is more prevalent in those over the age of 50 as there is a monoclonal protein present in 3% of those 50 and years older and 5% of those 70 years and older , placing those 50 and older at increased risk of MGRS.
MGRS disorders generally do not respond well to immunosuppressive treatment. MGRS disorders also have a greater than 90% rate of recurrence if the monoclonal gammopathy is not eliminated either before or immediately after a renal transplant. People with MGRS are at risk of progression to the corresponding hematologic malignancy.