PMID- 14712438
OWN - NLM
STAT- MEDLINE
DCOM- 20040414
LR  - 20220331
IS  - 1523-6838 (Electronic)
IS  - 0272-6386 (Linking)
VI  - 43
IP  - 1
DP  - 2004 Jan
TI  - Long-term outcome of renal transplantation in light-chain deposition disease.
PG  - 147-53
AB  - BACKGROUND: Light-chain deposition disease (LCDD) is a monoclonal gammopathy 
      characterized by nonamyloid deposition of light chain in various organs. A small 
      number of kidney transplantations have been performed on LCDD patients in whom 
      end-stage renal disease (ESRD) developed. METHODS: The authors retrospectively 
      reviewed the clinical and histologic findings and outcome of 7 patients with LCDD 
      who underwent kidney transplantation at our institution. RESULTS: Renal 
      insufficiency, hypertension, and proteinuria were present in all 7 patients. 
      Proteinuria level was greater than 3.5 g/24 h in 3 patients. Three patients had 
      microscopic hematuria. Monoclonal protein was detected in the serum in 3 
      patients, urine in 5, and was undetectable in 2. Median age at presentation was 
      42.7 (range, 33 to 58) years. The most common renal biopsy findings were 
      mesangial expansion, mesangial nodules, tubular basement membrane thickening, and 
      tubular atrophy. Kappa light chain was detected in all 7 renal biopsy results. 
      Five patients were on dialysis before transplantation. LCDD recurred after a 
      median of 33.3 (range, 2 to 45) months in 5 of the 7 patients. One patient 
      remains on dialysis, whereas the other 4 have died. One patient died of 
      progression of multiple myeloma 3 months after kidney transplantation without 
      evidence of recurrence. Only 1 patient remains recurrence free after 13 years 
      with normal renal allograft function. CONCLUSION: Although long-term benefits are 
      occasionally seen, renal allograft survival is reduced significantly in LCDD 
      patients. Kidney transplantation should not be an option for LCDD patients unless 
      measures have been taken to reduce light chain production.
FAU - Leung, Nelson
AU  - Leung N
AD  - Division of Nephrology, Department of Internal Medicine, Mayo Clinic, Rochester, 
      MN 55905, USA.
FAU - Lager, Donna J
AU  - Lager DJ
FAU - Gertz, Morie A
AU  - Gertz MA
FAU - Wilson, Kirk
AU  - Wilson K
FAU - Kanakiriya, Sharan
AU  - Kanakiriya S
FAU - Fervenza, Fernando C
AU  - Fervenza FC
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am J Kidney Dis
JT  - American journal of kidney diseases : the official journal of the National Kidney 
      Foundation
JID - 8110075
RN  - 0 (Immunoglobulin Light Chains)
SB  - IM
MH  - Adult
MH  - Humans
MH  - *Immunoglobulin Light Chains
MH  - Kidney/pathology
MH  - Kidney Failure, Chronic/etiology/*surgery
MH  - *Kidney Transplantation
MH  - Middle Aged
MH  - Paraproteinemias/complications/pathology/*surgery
MH  - Retrospective Studies
MH  - Treatment Outcome
EDAT- 2004/01/09 05:00
MHDA- 2004/04/15 05:00
CRDT- 2004/01/09 05:00
PHST- 2004/01/09 05:00 [pubmed]
PHST- 2004/04/15 05:00 [medline]
PHST- 2004/01/09 05:00 [entrez]
AID - S0272638603012277 [pii]
AID - 10.1053/j.ajkd.2003.09.020 [doi]
PST - ppublish
SO  - Am J Kidney Dis. 2004 Jan;43(1):147-53. doi: 10.1053/j.ajkd.2003.09.020.