Abstract: As an organ injury caused by abnormal proliferation of small plasma cells or B lymphocytes,monoclonal immunoglobulin disease involves skin,heart,kidney and peripheral nerve. With a large variety of pathological manifestations,it has a direct mechanism of kidney injury through a direct deposition of kidney tissue and an indirect mechanism of kidney injury caused by monoclonal immunoglobulin as antibody activated complement alternative pathway. This review summarized different mechanisms of monoclonal immunoglobulin disease of renal significance.