Diagnosis of MGRS in Patients With Paraproteinemias: Clinical, Anatomopathological and Pathophysiological Study

NCT03629561 | Unknown DMC

• 1 other identifier: T.I. N° 12702/18/H
• Study Type: observational
• Target: 15
• Locations: 1 country
• Sites: 1

Brief Summary

This is the first prospective study which evaluate patients with small B-cell clones to diagnose monoclonal gammopathy of renal significance (MGRS) and characterize it clinically, anatomopathologically and pathophysiologically taking int account a geriatric approach.

Conditions

Monoclonal Gammopathy of Renal Significance

Keywords

"Paraproteinemias"[Mesh]; "Kidney Diseases"[Mesh]

Outcome Measures

Primary Outcomes (1)

• Renal histopathology compatible with MGRS

  through study completion, an average of 1 year

Secondary Outcomes (1)

• Renal physiopathological changes

  through study completion, an average of 1 year

Eligibility Criteria

• Age: 18 Years - 89 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Hematological or nephrological patients

You may qualify if:

• Paraproteinemias

You may not qualify if:

• Multiple Myeloma
• Waldenstrom Macroglobulinemia
• Chronic Lymphocytic Leukemia
• Malignant Lymphoma
• Monoclonal gammopathy of unknown significance (MGUS) secondary to Infections
• MGUS secondary to Autoimmune Diseases
• Uncompleted hematological evaluation
• Renal tumor except for cysts Bosniak type I/II
• Other malignant neoplasia
• Unresolved obstructive uropathy
• Patients with only one kidney except for renal transplant
• Co-morbidities which would limit the ability to receive aggressive therapeutic intervention
• Fragile old people
• Pregnancy
• Prison

Sponsors & Collaborators

• Academia Nacional de Medicina: lead

Study Sites (1)

Academia Nacional de Medicina

Buenos Aires, 1425ASU, Argentina

RECRUITING

Related Publications (29)

• Ciocchini M, Arbelbide J, Musso CG. Monoclonal gammopathy of renal significance (MGRS): the characteristics and significance of a new meta-entity. Int Urol Nephrol. 2017 Dec;49(12):2171-2175. doi: 10.1007/s11255-017-1594-y. Epub 2017 Apr 19.

  PMID: 28425076 BACKGROUND

• Ciocchini M, Musso CG. What is the place of POEMS syndrome in the current classification of monoclonal gammopathies of renal significance? Int Urol Nephrol. 2018 Feb;50(2):383-384. doi: 10.1007/s11255-017-1739-z. Epub 2017 Nov 13. No abstract available.

  PMID: 29134615 BACKGROUND

• Ciocchini M, Musso CG. Which should be the correct treatment for monoclonal gammopathy of renal significance with complement alternative pathway dysregulation (C3 glomerulopathy and atypical hemolytic uremic syndrome): clone-directed or anticomplement therapy? Int Urol Nephrol. 2018 Jul;50(7):1365-1366. doi: 10.1007/s11255-018-1896-8. Epub 2018 May 28. No abstract available.

  PMID: 29808447 BACKGROUND

• Rosner MH, Edeani A, Yanagita M, Glezerman IG, Leung N; American Society of Nephrology Onco-Nephrology Forum. Paraprotein-Related Kidney Disease: Diagnosing and Treating Monoclonal Gammopathy of Renal Significance. Clin J Am Soc Nephrol. 2016 Dec 7;11(12):2280-2287. doi: 10.2215/CJN.02920316. Epub 2016 Aug 15.

  PMID: 27526705 BACKGROUND

• Chauvet S, Fremeaux-Bacchi V, Petitprez F, Karras A, Daniel L, Burtey S, Choukroun G, Delmas Y, Guerrot D, Francois A, Le Quintrec M, Javaugue V, Ribes D, Vrigneaud L, Arnulf B, Goujon JM, Ronco P, Touchard G, Bridoux F. Treatment of B-cell disorder improves renal outcome of patients with monoclonal gammopathy-associated C3 glomerulopathy. Blood. 2017 Mar 16;129(11):1437-1447. doi: 10.1182/blood-2016-08-737163. Epub 2017 Jan 9.

  PMID: 28069603 BACKGROUND

• Leung N, Nasr SH. A Patient with Abnormal Kidney Function and a Monoclonal Light Chain in the Urine. Clin J Am Soc Nephrol. 2016 Jun 6;11(6):1073-1082. doi: 10.2215/CJN.10641015. Epub 2016 Mar 18.

  PMID: 26992418 BACKGROUND

• Motwani SS, Herlitz L, Monga D, Jhaveri KD, Lam AQ; American Society of Nephrology Onco-Nephrology Forum. Paraprotein-Related Kidney Disease: Glomerular Diseases Associated with Paraproteinemias. Clin J Am Soc Nephrol. 2016 Dec 7;11(12):2260-2272. doi: 10.2215/CJN.02980316. Epub 2016 Aug 15.

  PMID: 27526706 BACKGROUND

• Fish R, Pinney J, Jain P, Addison C, Jones C, Jayawardene S, Booth J, Howie AJ, Ghonemy T, Rajabali S, Roberts D, White L, Khan S, Morgan M, Cockwell P, Hutchison CA. The incidence of major hemorrhagic complications after renal biopsies in patients with monoclonal gammopathies. Clin J Am Soc Nephrol. 2010 Nov;5(11):1977-80. doi: 10.2215/CJN.00650110. Epub 2010 Jul 22.

  PMID: 20651154 BACKGROUND

• Sethi S, D'Agati VD, Nast CC, Fogo AB, De Vriese AS, Markowitz GS, Glassock RJ, Fervenza FC, Seshan SV, Rule A, Racusen LC, Radhakrishnan J, Winearls CG, Appel GB, Bajema IM, Chang A, Colvin RB, Cook HT, Hariharan S, Herrera Hernandez LP, Kambham N, Mengel M, Nath KA, Rennke HG, Ronco P, Rovin BH, Haas M. A proposal for standardized grading of chronic changes in native kidney biopsy specimens. Kidney Int. 2017 Apr;91(4):787-789. doi: 10.1016/j.kint.2017.01.002.

  PMID: 28314581 BACKGROUND

• Moutzouris DA, Herlitz L, Appel GB, Markowitz GS, Freudenthal B, Radhakrishnan J, D'Agati VD. Renal biopsy in the very elderly. Clin J Am Soc Nephrol. 2009 Jun;4(6):1073-82. doi: 10.2215/CJN.00990209. Epub 2009 May 14.

  PMID: 19443626 BACKGROUND

• Trimarchi H, Barratt J, Cattran DC, Cook HT, Coppo R, Haas M, Liu ZH, Roberts IS, Yuzawa Y, Zhang H, Feehally J; IgAN Classification Working Group of the International IgA Nephropathy Network and the Renal Pathology Society; Conference Participants. Oxford Classification of IgA nephropathy 2016: an update from the IgA Nephropathy Classification Working Group. Kidney Int. 2017 May;91(5):1014-1021. doi: 10.1016/j.kint.2017.02.003. Epub 2017 Mar 22.

  PMID: 28341274 BACKGROUND

• Javaugue V, Bouteau I, Sirac C, Quellard N, Diolez J, Colombo A, Desport E, Ecotiere L, Goujon JM, Fermand JP, Touchard G, Jaccard A, Bridoux F. [Classification and therapeutic management of monoclonal gammopathies of renal significance]. Rev Med Interne. 2018 Mar;39(3):161-170. doi: 10.1016/j.revmed.2017.03.012. Epub 2017 Apr 27. French.

  PMID: 28457684 BACKGROUND

• Borza DB, Chedid MF, Colon S, Lager DJ, Leung N, Fervenza FC. Recurrent Goodpasture's disease secondary to a monoclonal IgA1-kappa antibody autoreactive with the alpha1/alpha2 chains of type IV collagen. Am J Kidney Dis. 2005 Feb;45(2):397-406. doi: 10.1053/j.ajkd.2004.09.029.

  PMID: 15685519 BACKGROUND

• Vignon M, Cohen C, Faguer S, Noel LH, Guilbeau C, Rabant M, Higgins S, Hummel A, Hertig A, Francois H, Lequintrec M, Vilaine E, Knebelmann B, Pourrat J, Chauveau D, Goujon JM, Javaugue V, Touchard G, El Karoui K, Bridoux F. The clinicopathologic characteristics of kidney diseases related to monotypic IgA deposits. Kidney Int. 2017 Mar;91(3):720-728. doi: 10.1016/j.kint.2016.10.026. Epub 2017 Jan 6.

  PMID: 28069266 BACKGROUND

• Stokes MB, Valeri AM, Herlitz L, Khan AM, Siegel DS, Markowitz GS, D'Agati VD. Light Chain Proximal Tubulopathy: Clinical and Pathologic Characteristics in the Modern Treatment Era. J Am Soc Nephrol. 2016 May;27(5):1555-65. doi: 10.1681/ASN.2015020185. Epub 2015 Sep 15.

  PMID: 26374607 BACKGROUND

• Eirin A, Irazabal MV, Gertz MA, Dispenzieri A, Lacy MQ, Kumar S, Sethi S, Nasr SH, Cornell LD, Fidler ME, Fervenza FC, Leung N. Clinical features of patients with immunoglobulin light chain amyloidosis (AL) with vascular-limited deposition in the kidney. Nephrol Dial Transplant. 2012 Mar;27(3):1097-101. doi: 10.1093/ndt/gfr381. Epub 2011 Nov 7.

  PMID: 22067518 BACKGROUND

• Sicard A, Karras A, Goujon JM, Sirac C, Bender S, Labatut D, Callard P, Sarkozy C, Essig M, Vanhille P, Provot F, Nony A, Nochy D, Ronco P, Bridoux F, Touchard G. Light chain deposition disease without glomerular proteinuria: a diagnostic challenge for the nephrologist. Nephrol Dial Transplant. 2014 Oct;29(10):1894-902. doi: 10.1093/ndt/gfu045. Epub 2014 Mar 11.

  PMID: 24619059 BACKGROUND

• Messias NC, Walker PD, Larsen CP. Paraffin immunofluorescence in the renal pathology laboratory: more than a salvage technique. Mod Pathol. 2015 Jun;28(6):854-60. doi: 10.1038/modpathol.2015.1. Epub 2015 Feb 13.

  PMID: 25676556 BACKGROUND

• Larsen CP, Ambuzs JM, Bonsib SM, Boils CL, Cossey LN, Messias NC, Silva FG, Wang YH, Gokden N, Walker PD. Membranous-like glomerulopathy with masked IgG kappa deposits. Kidney Int. 2014 Jul;86(1):154-61. doi: 10.1038/ki.2013.548. Epub 2014 Jan 15.

  PMID: 24429395 BACKGROUND

• Ramirez-Alvarado M, Barnidge DR, Murray DL, Dispenzieri A, Marin-Argany M, Dick CJ, Cooper SA, Nasr SH, Ward CJ, Dasari S, Jimenez-Zepeda VH, Leung N. Assessment of renal response with urinary exosomes in patients with AL amyloidosis: A proof of concept. Am J Hematol. 2017 Jun;92(6):536-541. doi: 10.1002/ajh.24717. Epub 2017 May 4.

  PMID: 28295502 BACKGROUND

• Sharma SG, Bomback AS, Radhakrishnan J, Herlitz LC, Stokes MB, Markowitz GS, D'Agati VD. The modern spectrum of renal biopsy findings in patients with diabetes. Clin J Am Soc Nephrol. 2013 Oct;8(10):1718-24. doi: 10.2215/CJN.02510213. Epub 2013 Jul 25.

  PMID: 23886566 BACKGROUND

• Paueksakon P, Revelo MP, Horn RG, Shappell S, Fogo AB. Monoclonal gammopathy: significance and possible causality in renal disease. Am J Kidney Dis. 2003 Jul;42(1):87-95. doi: 10.1016/s0272-6386(03)00412-8.

  PMID: 12830460 BACKGROUND

• Hutchison CA, Harding S, Hewins P, Mead GP, Townsend J, Bradwell AR, Cockwell P. Quantitative assessment of serum and urinary polyclonal free light chains in patients with chronic kidney disease. Clin J Am Soc Nephrol. 2008 Nov;3(6):1684-90. doi: 10.2215/CJN.02290508.

  PMID: 18945993 BACKGROUND

• Helal I, Fick-Brosnahan GM, Reed-Gitomer B, Schrier RW. Glomerular hyperfiltration: definitions, mechanisms and clinical implications. Nat Rev Nephrol. 2012 Feb 21;8(5):293-300. doi: 10.1038/nrneph.2012.19.

  PMID: 22349487 BACKGROUND

• Cachat F, Combescure C, Cauderay M, Girardin E, Chehade H. A systematic review of glomerular hyperfiltration assessment and definition in the medical literature. Clin J Am Soc Nephrol. 2015 Mar 6;10(3):382-9. doi: 10.2215/CJN.03080314. Epub 2015 Jan 7.

  PMID: 25568216 BACKGROUND

• Schaeffner ES, Ebert N, Delanaye P, Frei U, Gaedeke J, Jakob O, Kuhlmann MK, Schuchardt M, Tolle M, Ziebig R, van der Giet M, Martus P. Two novel equations to estimate kidney function in persons aged 70 years or older. Ann Intern Med. 2012 Oct 2;157(7):471-81. doi: 10.7326/0003-4819-157-7-201210020-00003.

  PMID: 23027318 BACKGROUND

• Saeki T, Kawano M. IgG4-related kidney disease. Kidney Int. 2014 Feb;85(2):251-7. doi: 10.1038/ki.2013.393. Epub 2013 Oct 9.

  PMID: 24107849 BACKGROUND

• Musso CG, Reynaldi J, Martinez B, Pierangelo A, Vilas M, Algranati L. Renal reserve in the oldest old. Int Urol Nephrol. 2011 Mar;43(1):253-6. doi: 10.1007/s11255-010-9769-9. Epub 2010 Jul 1.

  PMID: 20593305 BACKGROUND

• Jhaveri KD, Shah HH, Patel C, Kadiyala A, Stokes MB, Radhakrishnan J. Glomerular diseases associated with cancer, chemotherapy, and hematopoietic stem cell transplantation. Adv Chronic Kidney Dis. 2014 Jan;21(1):48-55. doi: 10.1053/j.ackd.2013.08.003.

  PMID: 24359986 BACKGROUND

Biospecimen

Retention: SAMPLES WITH DNA

Blood,Urine,Renal tissue

Central Study Contacts

Mariana Ciocchini, Nephrologist

CONTACT

+54 9 11 6172 2738; marianaciocchini@pm.me

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 2 Years
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: August 5, 2018
• First Posted: August 14, 2018
• Study Start: February 23, 2019
• Primary Completion: November 1, 2020
• Study Completion: February 1, 2021
• Last Updated: February 26, 2019

Record last verified: 2018-07

Locations

AR (1)