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Diagnosed with SMM, SPB, or MGUS?

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MGUS- Kidney Health?

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And yes, there is a tiny amount of kidney damage. I’m guessing that your type of monoclonal proteins are damaging your kidney health.”

Hello. My name is Brook. I am 42 years old and an a very fit active nurse in my last year to be a Family Nurse Practitioner. I had some protein in my urine over the past several years on spot checks (for physicals) that I thought was from my very intense workouts. I decided to go get my kidney health checked out this April.  After a series of tests I have been diagnosed with MGUS (monoclonal gammopathy of undetermined significance) -which I was extremely relieved about because I was sure it was Multiple Myeloma.
I go back to my oncologist  every 3 months for repeat labs and my 1st appointment back is the end of August. My problem I’m worried about is my kidney health.
I feel great and eat pretty healthy. I have been trying to stick to plant based diet. I’ve cut out my caffeine. 
 
The nephrologist office hasn’t put in my last labs. The ones from April are in and:
  • My GFR was 87-
  • My creatinine was 0.83 and BUN was 8-
  • My plasma cell % on my bone marrow biopsy was 2% – 
  • my protein had went up from 0.65grams to 8.76 grams
My nephrologist said that was the higher of the 2 numbers so he went with it and that’s why he classified me as MGUS instead of MM. 
 
 I’ve been a nurse for 22 years and I’ve always been healthy. I run 7 miles a day at least 3-4 days a week and do HIIT training. I feel very good but idk if I’m being paranoid or not – but I’ve felt some twinges around my kidneys that I’m just praying is muscular. 
 
I’ve got a call into Dr Yenhert, my nephrologist to ask him some questions. I see my oncologist again the last Thursday in August for bloodwork and see Dr Graham on September 3. I’m so scared that my numbers will be up. I’m a Christian and do not want to walk in fear but I will tell you- I’ve been terrified! Finding out it was MGUS instead has helped me a lot but I still worry because of my kidneys mainly. I appreciate any advice you have and prayers too! 
 
Can you please help me? I wanna do everything I can to protect my kidneys and I prefer non-toxic therapies. Brook

Hi Brook-
 
My method for thinking through your situation is to excerpt your questions and comments in order to present my thinking to you. 
 
1) “I feel great and eat pretty healthy. I have been trying to stick to plant based diet. I’ve cut out my caffeine.
 
Right off the bat you are ahead of the majority of MGUS patients. By exercising, eating nutritiously (mostly fruits and veggies), you are young, all good, all positive prognostic indicators.
2) “My GFR was 87-
 
According to National Kidney Foundation, the normal GFR function is 90 or higher. At 87, your kidney function is a bit low. 
 
3) “My creatinine was 0.83 and BUN was 8-
 
 Normal creatinine clearance for healthy women is 88-128 mL/min. Again, your creatinine is a bit low.
According to the Mayo Clinic, normal BUN range is “ around 7 to 20 mg/dL (2.5 to 7.1 mmol/L) is considered normal.” So your number of 8 is the low end of the normal range. 
 
4) “My plasma cell % on my bone marrow biopsy was 2% –
 
That is the lowest bone marrow biopsy number I’ve ever seen. Yes, you have a “monoclonal gammopathy” but it is quite small…
 
5) “my protein had went up from 0.65grams to 8.76 grams
 
Serum protein, total protein? I’m not sure what to make of this number without looking as your diagnostic work-up so I’ll just go with the first 3 numbers. 
 
To give you a thorough assessment of your pre-MM situation, I should study all of your diagnostic testing results. Blood, bone, etc. health, not just your kidney health. But for this email, I will focus just on your kidney health. 
 
All to say yes, you have monoclonal gammopathy of undetermined significance. And yes, there is a tiny amount of kidney damage. I’m guessing that your type of monoclonal proteins are clogging up your kidney function. 
 
Like all pre-MM patients I encourage you to take your condition seriously. I don’t think you need to “walk in fear” but I would say that MGUS  is a health issue that requires some focus and effort on your part to manage. 
 
When I say “manage” I am saying that I know of many MGUS patients who manage their situation for years without becoming a full-blown multiple myeloma patient. 
 
An anti-angiogenic focused diet as well as nutritional supplementation such as curcumin, black seed oil, vitamin D3, and omega-3 fatty acids have documented kidney benefits plus are help kill MM. 
 
Please read the studies linked below. 
 
Also, dehydration hurts kidney function according to studies. It sounds like you work out a lot. Drink plenty of liquids. Maybe lemon water… 
 
I think if you focus on this aspect of your health you will manage your pre-MM well for decades to come. Let me know if you have any questions. 
 
Hang in there, 
 
David Emerson
  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Creatinine (Low, High, Blood Test Results Explained)

Creatinine clearance can also be more directly measured by collecting a 24-hour urine sample and then drawing a blood sample. The creatinine levels in both urine and blood are determined and compared. Normal creatinine clearance for healthy women is 88-128 mL/min. and 97 to 137 mL/min. in males (normal levels may vary slightly between labs)

What is a normal eGFR number?

“In adults, the normal eGFR number is more than 90. eGFR declines with age, even in people without kidney disease. See chart below for average estimated eGFR based on age.

Age (years) Average estimated eGFR
20–29 116
30–39 107
40–49 99
50–59 93
60–69 85
70+

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