{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T17:24:08Z","timestamp":1790097848874,"version":"4.0.1"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,12,17]],"date-time":"2024-12-17T00:00:00Z","timestamp":1734393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"},{"start":{"date-parts":[[2024,12,17]],"date-time":"2024-12-17T00:00:00Z","timestamp":1734393600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2024,12,17]],"date-time":"2024-12-17T00:00:00Z","timestamp":1734393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>About 4\u20137% of renal biopsies show a monoclonal gammopathy-related nephropathy, such as AL amyloidosis, cast nephropathy, or light chain deposition disease. Both a high prevalence and a causal role of monoclonal gammopathy have been observed in patients with C3 glomerulopathy or thrombotic microangiopathy, although a definitive causative role cannot be established in most cases (potentially monoclonal gammopathy-related nephropathies). A coexisting monoclonal gammopathy has been identified in many cases of nephropathy without a defined causative role (monoclonal gammopathy-unrelated nephropathies). The aim of this study was to investigate the prevalence and distribution of monoclonal gammopathy in patients who underwent a\u00a0renal biopsy and assess its possible causal role in nephropathies not ordinarily related to monoclonal gammopathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In our single-center retrospective observational study, we considered patients who underwent native kidney biopsy from 2009 to 2023 at the Nephrology Unit, Careggi University Hospital, Florence (Italy)\u00a0and for whom a complete monoclonal gammopathy workup (serum electrophoresis, serum and urinary immunofixation, serum free light chains) was available.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 827 patients were included: 208 (25%) had a monoclonal gammopathy: in\u00a0104 cases the monoclonal gammopathy\u00a0was\u00a0unrelated to\u00a0the\u00a0kidney disease; 87 subjects showed renal pathology related to monoclonal gammopathy (monoclonal gammopathy-related nephropathies). Patients with thrombotic microangiopathy and C3 glomerulopathy (potentially monoclonal gammopathy-related nephropathies) exhibited a prevalence of monoclonal gammopathy\u2009&amp;gt;\u200930%. In a subgroup of diagnoses (e.g. tubulointerstitial nephritis, membranoproliferative glomerulonephritis) a possible causal and\/or prognostic role of a concomitant monoclonal gammopathy may be hypothesized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In our cohort, one fourth of patients undergoing a\u00a0renal biopsy had a monoclonal gammopathy, although in half of them the monoclonal gammopathy did not have a causative role\u00a0in the kidney disease.\u00a0Hence, it is impossible to conclude that a monoclonal gammopathy in the context of renal disease equates to a causal association without performing a renal biopsy because of the high frequency of monoclonal gammopathy in patients undergoing a kidney biopsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s40620-024-02160-x","type":"journal-article","created":{"date-parts":[[2024,12,17]],"date-time":"2024-12-17T11:48:40Z","timestamp":1734436120000},"page":"541-550","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Monoclonal gammopathy is present in one fourth of patients undergoing renal biopsy but is pathogenic only in half of them"],"prefix":"10.1093","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9949-3543","authenticated-orcid":false,"given":"Marco","family":"Allinovi","sequence":"first","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Unit, Careggi University Hospital, Largo Brambilla, 3, 50134, Florence, Italy 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Aterini","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Unit, Careggi University Hospital, Largo Brambilla, 3, 50134, Florence, Italy 1"},{"name":"Department of Biomedical Experimental and Clinical Sciences \u201cMario Serio\u201d, University of Florence, Florence, Italy 2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Caroti","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Unit, Careggi University Hospital, Largo Brambilla, 3, 50134, Florence, Italy 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Antognoli","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Unit, Careggi University Hospital, Largo Brambilla, 3, 50134, Florence, Italy 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calogero Lino","family":"Cirami","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Unit, Careggi University Hospital, Largo Brambilla, 3, 50134, Florence, Italy 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