Clinicopathological features of renal amyloidosis: A single-center study on 47 cases

Abstract

The correlations between the clinicopathological features and the long-term outcomes of renal amyloidosis (RA) were analyzed with a view to develop strategies for improving diagnosis and prognosis of RA. We retrospectively reviewed the clinicopathological characteristics of 47 patients diagnosed with RA between 2004 and 2014 at the Wuhan Union Hospital. The data on the renal histology, clinical manifestations, and prognosis of RA patients were retrieved from the hospital records and characteristic patterns were identified. The histological changes in the kidneys were correlated with the clinical manifestations of RA. Additionally, most RA patients in this study had decreased serum levels of κ light chain and increased urine levels of κ and λ light chains as well as presence of M-protein in the urine and serum. Patients with early RA showed no specific pathognomonic symptoms. Bleeding associated with diagnostic renal biopsy was rare. We recommend that the routine work-up of patients aged over 40 years and presenting with non-diabetic nephropathy includes the non-invasive tests for the measurement of serum and urine levels of κ and λ light chains as well as protein electrophoresis tests for the presence of urinary and serum M-protein. Additionally, such patients should undergo renal biopsy screening with Cong-red staining to ensure early diagnosis of RA and improve their survival, since the risk of hemorrhage related to renal biopsy screening is low at early stages of RA.

Construction of Remote Patient Perceived Value Satisfaction Model with Online Medical Service for Specialties Based on ACSIM and TAM

“…The elements of synergy capabilities mainly include culture synergy, strategy synergy, system synergy, information synergy, resource synergy, organization synergy, innovation synergy, and compact synergy. In particular, the coe cients of variables such as strategy synergy and innovation synergy are relatively high [17]. Besides, the synergy effect can be measured through calculating e ciency and cost, which is related to the desire for innovation synergy, including innovation in resource synergy, operation synergy, and value synergy [18].…”