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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">nefr</journal-id><journal-title-group><journal-title xml:lang="ru">Нефрология</journal-title><trans-title-group xml:lang="en"><trans-title>Nephrology (Saint-Petersburg)</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1561-6274</issn><issn pub-type="epub">2541-9439</issn><publisher><publisher-name>Pavlov First Saint-Petersburg State Medical University</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.36485/1561-6274-2019-236-9-28</article-id><article-id custom-type="elpub" pub-id-type="custom">nefr-1767</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ПЕРЕДОВАЯ СТАТЬЯ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>LEADING ARTICLE</subject></subj-group></article-categories><title-group><article-title>Моноклональная гаммапатия ренального значения: консенсус гематологов и нефрологов России по введению нозологии, диагностике и обоснованности клон-ориентированной терапии</article-title><trans-title-group xml:lang="en"><trans-title>Monoclonal gammopathy of renal signifi cance: Consensus of hematologists and nephrologists of Russia on the establishment of nosology, diagnostic approach and rationale for clone specific treatment</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7863-9080</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Смирнов</surname><given-names>А. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Smirnov</surname><given-names>A. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Смирнов Алексей Владимирович, профессор, доктор медицинских наук  Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова, директор Научно-исследовательского института нефрологии, заведующий кафедрой пропедевтики внутренних болезней с клиникой</p><p>197022,  Санкт-Петербург, ул. Л. Толстого, д. 17</p></bio><bio xml:lang="en"><p>Alexey V. Smirnov, Prof.,  MD, PhD, DMedSci Pavlov First St-Petersburg State Medical University, Director of the Scientifi c Research Institute of Nephrology, Head of Department of Propaedeutics of Internal Diseases</p><p>197022,  St-Petersburg, L. Tolstoy str., 17</p></bio><email xlink:type="simple">smirnov@nephrolog.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1235-4530</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Афанасьев</surname><given-names>Б. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Afanasyev</surname><given-names>B. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Афанасьев Борис Владимирович, профессор, доктор медицинских наук Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова, директор Научно-исследовательского института детской онкологии, гематологии и трансплантологии костного мозга им. Р.М. Горбачевой, заведующий кафедрой гематологии, трансфузиологии, трансплантологии факультета постдипломного образования</p><p>197022,Санкт-Петербург, ул. Рентгена, д. 12</p><p> </p></bio><bio xml:lang="en"><p>Boris V. Afanasyev, Prof.,  MD, PhD, DMedSci Pavlov First St.-Petersburg State Medical University, director of Raisa Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation, Head of Department of Hematology, Transfusiology, Transplantology of Postgraduate Education Faculty</p><p>197022,  Saint-Petersburg, Rentgen str., 12.</p></bio><email xlink:type="simple">bvafan@gmail.com</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0995-1801</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Поддубная</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Poddubnaya</surname><given-names>I. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Поддубная Ирина Владимировна, профессор, доктор медицинских наук, академик РАН Российская медицинская академия непрерывного профессионального образования, заведующая кафедрой онкологии</p><p>115230,Москва, Кашиpское шоссе, д. 23.</p></bio><bio xml:lang="en"><p>Irina V. Poddubnaya, Prof.,  MD, PhD, DMedSci, Corresponding Member of Russian Academy of Science Russian Medical Academy for Postgraduate Education, Head of Oncology Department</p><p>115230, Moscow, Kashirskoye sh., 23.</p></bio><email xlink:type="simple">poddubnaya_irina@inbox.ru</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7179-5520</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Добронравов</surname><given-names>В. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Dobronravov</surname><given-names>V. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Добронравов Владимир Александрович, профессор, доктор медицинских наук Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова, заместитель директора Научно-исследовательского института нефрологии по научной работе</p><p>197022, Санкт-Петербург, ул. Л. Толстого, д. 17</p></bio><bio xml:lang="en"><p>Vladimir A. Dobronravov, Prof.,  MD, PhD, DMedSci Pavlov First St.-Petersburg State Medical University, Vice Director of Research Institute of Nephrology</p><p>197022,  St. Petersburg, L. Tolstoy str., 17</p></bio><email xlink:type="simple">dobronravov@nephrolog.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8141-4488</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Храброва</surname><given-names>М. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Khrabrova</surname><given-names>M. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Храброва Мария Сергеевна, доцент, кандидат медицинских наук, кафедра пропедевтики внутренних болезней</p><p>197022,  Санкт-Петербург, ул. Л. Толстого, д. 17.</p></bio><bio xml:lang="en"><p>Maria S. Khrabrova, Associate prof.,  MD, PhD, Department of Propedeutics of Internal Diseases</p><p>197022,  Saint-Petersburg, L. Tolstoy str., 17.</p><p> </p></bio><email xlink:type="simple">hrabrovamc@gmail.com</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0178-7549</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Захарова</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Zakharova</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Захарова Елена Викторовна, доцент, кандидат медицинских наук  Городская клиническая больница им. С.П. Боткина, заведующая отделением нефрологии; доцент кафедры нефрологии Московского государственного медико-стоматологический университета им. А.И. Евдокимова; доцент кафедры нефрологии и диализа Российской медицинской академии непрерывного профессионального образования</p><p>125284, Москва, 2-й Боткинский пр-д, д. 5.</p><p> </p></bio><bio xml:lang="en"><p>Elena V. Zakharova, Associate prof.,  MD, PhD City Botkin Memorial Hospital, Chief of Nephrology Department; Nephrology and dialysis Department, Russian Medical Academy of Postgraduate Education; Nephrology Department, A.I. Yevdokimov Moscow State University of Medicine and Dentistry</p><p>125284,  Moscow, 2nd Botkinskiy proezd, 5</p></bio><email xlink:type="simple">helena.zakharova@gmail.com</email><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2490-1263</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Никитин</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Nikitin</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Никитин Евгений Александрович, профессор, доктор медицинских Городская клиническая больница им. С.П. Боткина, заведующий дневным стационаром гематологии, онкологии и химиотерапии; профессор кафедры гематологии и трансфузиологии Российской медицинской академии непрерывного профессионального образования</p><p>125284, Москва, 2-й Боткинский пр-д, д. 5.</p></bio><bio xml:lang="en"><p>Eugene A. Nikitin, Prof.,  MD, PhD, DMedSci City Botkin Memorial Hospital, Chief of Outpatient department for hematology, oncology and chemotherapy; professor of department of Hematology and Transfusiology, Russian Medical Academy of Postgraduate Education</p><p>125284,  Moscow, 2nd Botkinskiy proezd, 5</p></bio><email xlink:type="simple">eugene_nikitin@mail.ru</email><xref ref-type="aff" rid="aff-6"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1166-7308</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Козловская</surname><given-names>Л. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kozlovskaya</surname><given-names>L. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Козловская (Лысенко) Лидия Владимировна, профессор,  доктор медицинских наук Первый Московский государственный медицинский университет им. И.М. Сеченова; профессор кафедры внутренних, профессиональных болезней и ревматологии Института клинической медицины</p><p>119435,  Москва, ул. Россолимо, 11 стр. 5.</p></bio><bio xml:lang="en"><p>Lidia V. Kozlovskaya (Lysenko), Prof.,  MD, PhD, DMedSci I.M. Sechenov First Moscow State Medical University, professor of Department of Internal and occupational diseases and rheumatology of Institute of clinical medicine</p><p>119435,  Moscow, Rossolimo str., 11, build 5</p></bio><email xlink:type="simple">consult@tareevclinic.ru</email><xref ref-type="aff" rid="aff-7"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8007-5680</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бобкова</surname><given-names>И. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Bobkova</surname><given-names>I. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Бобкова Ирина Николаевна, профессор, доктор медицинских наук  Первый Московский государственный медицинский университет им. И.М. Сеченова; профессор кафедры внутренних, профессиональных болезней и ревматологии Института клинической медицины</p><p>119435,  Москва, ул. Россолимо, 11 стр. 5.</p></bio><bio xml:lang="en"><p>Irina N. Bobkova, Prof., MD, PhD, DMedSci I.M. Sechenov First Moscow State Medical University, professor of Department of Internal and occupational diseases and rheumatology of Institute of clinical medicine</p><p>119435,  Moscow, Rossolimo str., 11, build 5</p></bio><email xlink:type="simple">irbo.mma@mail.ru</email><xref ref-type="aff" rid="aff-7"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4260-0226</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Рамеев</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Rameev</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Рамеев Вилен Вилевич, доцент, кандидат медицинских наук  Первый Московский государственный медицинский университет им. И.М. Сеченова; доцент кафедры внутренних, профессиональных болезней и ревматологии Института клинической медицины</p><p>119435, Москва, ул. Россолимо, 11 стр. 5.</p><p> </p></bio><bio xml:lang="en"><p>Vilen V. Rameev, Associate prof., MD, PhD I.M. Sechenov First Moscow State Medical University, Department of Internal and occupational diseases and rheumatology of Institute of clinical medicine</p><p>119435,  Moscow, Rossolimo str., 11, build 5</p></bio><email xlink:type="simple">vvrameev@mail.ru</email><xref ref-type="aff" rid="aff-7"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2733-4524</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Батюшин</surname><given-names>М. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Batyushin</surname><given-names>M. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Батюшин Михаил Михайлович, профессор, доктор медицинских наук, профессор кафедры внутренних болезней</p><p>344022,  г. Ростов-на-Дону, пер. Нахичеванский, д. 29.</p><p> </p></bio><bio xml:lang="en"><p>Mikhail M. Batyushin, Prof.,  MD, PhD, DMedSci, professor of Department of Internal Medicine №2</p><p>344022,  Rostov-on-Don, Nakhichevansky ln, 29</p></bio><email xlink:type="simple">batjushin-m@rambler.ru</email><xref ref-type="aff" rid="aff-8"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4332-0114</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Моисеев</surname><given-names>И. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Moiseev</surname><given-names>I. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Моисеев Иван Сергеевич, доцент,  доктор медицинских наук Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова, заместитель директора Научноисследовательского института детской онкологии, гематологии и трансплантологии костного мозга им. Р.М. Горбачевой, доцент кафедры гематологии, трансфузиологии, трансплантологии факультета постдипломного образования</p><p>197022,  Санкт-Петербург, ул. Рентгена, д. 12</p></bio><bio xml:lang="en"><p>Ivan S. Moiseev, Associate prof.,  MD, PhD, DMedSci Pavlov First St.-Petersburg State Medical University, vice-director of Raisa Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation, ass. prof. of Department of Hematology, Transfusiology, Transplantology of Postgraduate Education Faculty</p><p>197022,  Saint-Petersburg, Rentgen str., 12</p></bio><email xlink:type="simple">moisiv@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Дарская</surname><given-names>Е. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Darskaya</surname><given-names>E. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Дарская Елена Игоревна, кандидат медицинских наук  Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова, заведующая отделением трансплантации костного мозга для взрослых Научноисследовательского института детской онкологии, гематологии и трансплантологии костного мозга им. Р.М. Горбачевой</p><p>197022,  Санкт-Петербург, ул. Рентгена, д. 12.</p><p> </p></bio><bio xml:lang="en"><p>Elena I. Darskaya, MD, PhD Pavlov First St.-Petersburg State Medical University, head of Department of Bone Marrow Transplantation for adults of Raisa Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation </p><p>197022,  Saint-Petersburg, Rentgen str., 12</p></bio><email xlink:type="simple">edarskaya@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Пирогова</surname><given-names>О. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Pirogova</surname><given-names>O. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Пирогова Ольга Владиславовна, кандидат медицинских наук  Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова, старший научный сотрудник Научно-исследовательского института детской онкологии, гематологии и трансплантологии костного мозга им. Р.М. Горбачевой</p><p>197022,  Санкт-Петербург, ул. Рентгена, д. 12.</p><p> </p></bio><bio xml:lang="en"><p>Olga V. Pirogova, MD, PhD Pavlov First St.-Petersburg State Medical University, senior scientist of Raisa Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation</p><p>197022,  Saint-Petersburg, Rentgen str., 12</p></bio><email xlink:type="simple">dr.pirogova@gmail.com</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4966-8146</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Менделеева</surname><given-names>Л. П.</given-names></name><name name-style="western" xml:lang="en"><surname>Mendeleeva</surname><given-names>L. P.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Менделеева Лариса Павловна, профессор, доктор медицинских наук  , заместитель генерального директора по научной работе и инновациям</p><p>125167, Москва, Новый Зыковский проезд, д. 4</p></bio><bio xml:lang="en"><p>Larisa P. Mendeleeva, Prof.,  MD, PhD, DMedSci, Vice-director</p><p>125167,  Moscow, Noviy Zykovskiy proezd, 4</p><p> </p></bio><email xlink:type="simple">mendeleeva.l@blood.ru</email><xref ref-type="aff" rid="aff-9"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бирюкова</surname><given-names>Л. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Biryukova</surname><given-names>L. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Бирюкова Людмила Семеновна, профессор, доктор медицинских наук  ФГБУ Национальный медицинский исследовательский центр гематологии, заведующий отделением полиорганной патологии и гемодиализа, доцент кафедры нефрологии и диализа Российской медицинской академии непрерывного профессионального образования</p><p>125167, Москва, Новый Зыковский проезд, д. 4</p></bio><bio xml:lang="en"><p>Ludmila S. Biryukova, Prof.,  MD, PhD National Research Center of Hematology, head of Polyorganic pathology and hemodialysis Department; associate prof. of Nephrology and dialysis Department, Russian Medical Academy of Postgraduate Education</p><p>125167, Moscow, Noviy Zykovskiy proezd, 4</p></bio><email xlink:type="simple">biryukova.l@blood.ru</email><xref ref-type="aff" rid="aff-10"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Научно-исследовательский институт нефрологии;&#13;
Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П.Павлова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Scientific Research Institute of Nephrology; &#13;
Pavlov First St-Petersburg State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Научно-исследовательский институт детской онкологии, гематологии и трансплантологии костного мозга им. Р.М. Горбачевой;&#13;
Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Raisa Gorbacheva Memorial Research Institute of Children Oncology, Hematology and Transplantation;&#13;
Pavlov First St-Petersburg State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Российская медицинская академия непрерывного профессионального образования</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Russian Medical Academy of Postgraduate Education</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П. Павлова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Pavlov First St-Petersburg State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>Московский государственный медико-стоматологический университет им. А.И. Евдокимова;&#13;
Российская медицинская академия непрерывного профессионального образования;&#13;
Городская клиническая больница им. С.П. Боткина</institution><country>Россия</country></aff><aff xml:lang="en"><institution>A.I. Yevdokimov Moscow State University of Medicine and Dentistry;&#13;
Russian Medical Academy of Postgraduate Education;&#13;
Nephrology Department, City Botkin Memorial Hospital</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-6"><aff xml:lang="ru"><institution>Российская медицинская академия непрерывного профессионального образования;&#13;
Городская клиническая больница им. С.П. Боткина</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Russian Medical Academy of Postgraduate Education;&#13;
City Botkin Memorial Hospital</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-7"><aff xml:lang="ru"><institution>Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>I.M. Sechenov First Moscow State Medical University (Sechenov University)</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-8"><aff xml:lang="ru"><institution>Ростовский государственный медицинский университет</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Rostov State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-9"><aff xml:lang="ru"><institution>Национальный медицинский исследовательский центр гематологии</institution><country>Россия</country></aff><aff xml:lang="en"><institution>National Research Center of Hematology</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-10"><aff xml:lang="ru"><institution>Российская медицинская академия непрерывного профессионального образования;&#13;
Национальный медицинский исследовательский центр гематологии</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Russian Medical Academy of Postgraduate Education;&#13;
National Research Center of Hematology</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2019</year></pub-date><pub-date pub-type="epub"><day>25</day><month>12</month><year>2019</year></pub-date><volume>23</volume><issue>6</issue><fpage>9</fpage><lpage>28</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Смирнов А.В., Афанасьев Б.В., Поддубная И.В., Добронравов В.А., Храброва М.С., Захарова Е.В., Никитин Е.А., Козловская Л.В., Бобкова И.Н., Рамеев В.В., Батюшин М.М., Моисеев И.С., Дарская Е.И., Пирогова О.В., Менделеева Л.П., Бирюкова Л.С., 2019</copyright-statement><copyright-year>2019</copyright-year><copyright-holder xml:lang="ru">Смирнов А.В., Афанасьев Б.В., Поддубная И.В., Добронравов В.А., Храброва М.С., Захарова Е.В., Никитин Е.А., Козловская Л.В., Бобкова И.Н., Рамеев В.В., Батюшин М.М., Моисеев И.С., Дарская Е.И., Пирогова О.В., Менделеева Л.П., Бирюкова Л.С.</copyright-holder><copyright-holder xml:lang="en">Smirnov A.V., Afanasyev B.V., Poddubnaya I.V., Dobronravov V.A., Khrabrova M.S., Zakharova E.V., Nikitin E.A., Kozlovskaya L.V., Bobkova I.N., Rameev V.V., Batyushin M.M., Moiseev I.S., Darskaya E.I., Pirogova O.V., Mendeleeva L.P., Biryukova L.S.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://journal.nephrolog.ru/jour/article/view/1767">https://journal.nephrolog.ru/jour/article/view/1767</self-uri><abstract><p>Моноклональная гаммапатия ренального значения (МГРЗ) представляет собой новую нозологическую группу в современной нефрологии и онкогематологии. Под МГРЗ понимают поражение почек, обусловленное действием нефротоксичного моноклонального иммуноглобулина, продуцируемого клоном В-клеточной линии, который не достигает критериев, необходимых для начала противоопухолевой терапии по онкогематологическим показаниям. Результатом воздействия моноклонального белка на почечную паренхиму является неуклонное прогрессирование дисфункции почек вплоть до утраты функции органа, что в соответствии с единой позицией международного консенсуса гематологов и нефрологов определенно указывает на необходимость клон-ориентированного лечения МГРЗ, несмотря на отсутствие критериальных онкогематологических показаний. Основной проблемой МГРЗ в Российской Федерации является недоступность для большинства пациентов своевременной диагностики и лечения данной патологии, что обусловлено, во-первых, недостаточной осведомленностью гематологов и нефрологов страны в отношении МГРЗ, во-вторых, отсутствием в большинстве медицинских учреждений необходимых диагностических ресурсов, в-третьих, отсутствием утвержденных рекомендаций и медико-экономических стандартов лечения этой болезни. Текст настоящего Консенсуса заключает в себе мнение специалистов Российской Федерации в отношении нозологической классификации, диагностики и подходов к терапии МГРЗ и основан на итогах проведенного совместного совещания ведущих гематологов и нефрологов страны. Совещание состоялось 15–16 марта 2019 года в рамках симпозиума «Плазмоклеточные дискразии и лимфопролиферативные заболевания: новые подходы к терапии», проведенного в Первом Санкт-Петербургском государственном медицинском университете им. акад. И.П. Павлова. Настоящий Консенсус гематологов и нефрологов призван наметить основные практические пути решения проблемы МГРЗ в Российской Федерации, которые кратко сформулированы в виде заключительных положений.</p></abstract><trans-abstract xml:lang="en"><p>Monoclonal gammopathy of renal significance (MGRS) is a new nosology in modern nephrology and oncohematology. MGRS is defined as kidney injury due to nephrotoxic monoclonal immunoglobulin produced by the B-cell line clone which does not reach the hematological criteria for specific treatment initiation. Monoclonal protein’s pathological effects on kidney parenchyma result in irreversible decline of kidney function till the end stage renal disease that in line with the position of International Consensus of hematologists and nephrologists determinates critical necessity for clone specific treatment in patients with MGRS despite the absence of hematological indications for treatment initiation. Main challenge of MGRS in Russian Federation is an inaccessibility of an in-time diagnostic and appropriate treatment for the great majority of patients due to the following reasons: i) limited knowledge about the MGRS among hematologists and nephrologists; ii) lack of necessary diagnostic resources in most health-care facilities; iii) lack of approved clinical recommendations and medical economic standards for treatment of this pathological entity. Consensus document comprises the opinion of experts – leading nephrologists and hematologists of Russian Federation – on the problem of MGRS including the incoherence in nosology classification, diagnostics approach and rationale for clone specific treatment. Consensus document is based on conclusions and agreements reached during the conference of leading nephrologists and hematologists of Russia which was held in the framework of symposia «Plasma cell dyscrasias and lymphoproliferative diseases: modern approaches to therapy», 15-16 of March 2019, Pavlov First St-Petersburg State Medical University, St-Petersburg, Russia. The present Consensus is intended to define the principal practical steps to resolve the problem of MGRS in Russian Federation that are summarized as final clauses.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>моноклональная гаммапатия ренального значения</kwd><kwd>моноклональная гаммапатия неопределенного значения</kwd><kwd>онконефрология</kwd><kwd>поражение почек</kwd><kwd>клон-ориентированное лечение</kwd><kwd>парапротеин</kwd><kwd>нефробиопсия</kwd><kwd>плазмоклеточные дискразии</kwd><kwd>легкие цепи</kwd></kwd-group><kwd-group xml:lang="en"><kwd>monoclonal gammopathy of renal significance</kwd><kwd>monoclonal gammopathy of undetermined significance</kwd><kwd>onconephrology</kwd><kwd>kidney injury</kwd><kwd>clone specific treatment</kwd><kwd>paraprotein</kwd><kwd>kidney biopsy</kwd><kwd>plasma cell dyscrasias</kwd><kwd>light chains</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Leung N, Bridoux F, Hutchison CA et al. 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