Nelson Leung, M.D., is interested in kidney diseases caused by monoclonal gammopathy.

Due to improvements in the detection of monoclonal proteins, the number of kidney diseases associated with monoclonal gammopathy has increased.

The disease in which Dr. Leung is most interested is immunoglobulin light chain amyloidosis. This is a disease caused by the overproduction of immunoglobulin light chains that form amyloid fibrils.

In particular, Dr. Leung's work revolves around improving current diagnostic techniques and redefining response criteria in these patients.

Focus areas

• Urinary exosomes for the detection of immunoglobulin light chain amyloidosis. Developing and optimizing a noninvasive method for the detection of amyloid involvement in the kidney.
• Renal response in patients with immunoglobulin light chain amyloidosis. Improving the current response criteria used to gauge response in the kidney after treatment in patients with immunoglobulin light chain amyloidosis.
• Myeloma kidney. Improving diagnostic tests and exploring new treatment options for cast nephropathy.
• Monoclonal gammopathy of renal significance. Improving diagnostic testing for monoclonal gammopathy involved in kidney disease and developing treatments effective at preventing development of end-stage kidney disease.

Significance to patient care

Perfecting a noninvasive diagnostic technique that can detect amyloid involvement in the kidney would be a tremendous advancement over current technology.

Currently, a renal biopsy is required, which is invasive and has a 5 percent chance of internal hemorrhage. A noninvasive procedure would eliminate the risk to the patient.

In addition, it could be done more often, allowing for more frequent assessments. This could be extremely helpful by detecting response and relapse much earlier than is currently possible.