ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005


The Latest on X

Kidney Week

Please note that you are viewing an archived section from 2023 and some content may be unavailable. To unlock all content for 2023, please visit the archives.

Abstract: SA-PO247

Proximal Tubulopathy Secondary to Chronic Lymphocytic Leukemia After COVID-19 Infection

Session Information

Category: Onconephrology

  • 1700 Onconephrology


  • Paredes, William Mauricio, SBH Health System, Bronx, New York, United States
  • Flores Chang, Marjorie Mailing, SBH Health System, Bronx, New York, United States
  • Flores Chang, Bessy Suyin, SBH Health System, Bronx, New York, United States

Light chain proximal tubulopathy is a rare kidney disorder that occurs when free light chains are filtered by the kidneys and then accumulate in the tubules, leading to kidney damage and dysfunction. This condition is often associated with multiple myeloma. While chronic lymphocytic leukemia (CLL) is not typically associated with light chain proximal tubulopathy, there have been rare cases reported in the medical literature. However, to our knowledge, no reports have been found of developing both conditions after a COVID-19 infection.

Case Description

A 60-year-old male with pre-DM presented were decreased appetite, fatigue, and dizziness his physical examination was unremarkable. Initial workup was significant for COVID-19 infection, serum creatinine of 3.2 mg/dL, GFR: 20 cc/min, however, was discharged for outpatient follow-up. Urinalysis showed proteinuria and hematuria (33 RBC per hpf), serum creatinine stable to 3.3 mg/dL, GFR: 20 cc/min, spot protein to creatinine ratio of 1.8 g, ANCA profile, hepatitis B and C serologies were non-reactive. Complement C3 slightly decreased 73 mg/dL (82-167mg/dL), serum-free light chains ratio of 14.6. Prior serum creatinine was 0.9 mg/ dl ~4 years prior. Kidney biopsy demonstrated focal endocapillary and extra capillary proliferative glomerulonephritis with apparent lgG1 kappa deposits (light chain proximal tubulopathy), supporting the diagnosis of monoclonal gammopathy of renal significance (MGRS). Hemato-oncology evaluation noted worsening weight loss since the COVID-19 infection and left supraclavicular and bilateral inguinal lymphadenopathy with palpable hepatosplenomegaly. He underwent a bone marrow biopsy showing atypical lymphocytosis, trisomy 12 in 45.5% of cells, and flow cytometry findings of the clonal B-cell population (60-65% of total), immunophenotypically represents (CLL). Treatment was started with Venetoclax, febuxostat, and obinutuzumab. His serum creatinine stabilized at 2.4 mg/dL with a GFR of 28 cc/min.


Chronic lymphocytic leukemia rarely can present with deposition of free light chains in the kidneys leading to Light chain proximal tubulopathy. We present a case of a patient who had this presentation after having a COVID-19 infection. To our knowledge, there have been no reported cases of MGRS or chronic lymphocytic leukemia after a COVID-19 infection.