Renal function at the time of renal biopsy as a predictor of prognosis in patients with primary AL-type amyloidosis

Osawa, Yutaka; Kawamura, Kazuko; Kondo, Daisuke; Imai, Naofumi; Ueno, Mitsuhiro; Nishi, Shinichi; Iino, Noriaki; Okada, Masami; Suzuki, Yasushi; Hoshino, Satoshi; Yamazaki, Hajime; Kishimoto, Hiroyuki; Shimada, Hideaki; Yamagishi, Tsuyoshi; Ishiyama, Tetsuya; Narita, Ichiei; Gejyo, Fumitake

doi:10.1007/s10157-004-0286-y

Cited by 15 publications

(10 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Cardiovascular disease and infection are two main causes of death. Oosawa [40] surveyed the clinical course of 21 patients with AL amyloidosis. Among them, 11 patients died after a mean period of 21.7 months after renal biopsy, whereas the other 10 who survived were followed up for 51.0 months.…”

Section: Clinical Diagnosis and Clinical Features Of Renal Amyloidosismentioning

confidence: 99%

New advances in renal amyloidosis

et al. 2008

Self Cite

View full text Add to dashboard Cite

Renal amyloidosis is a rare and intractable disease that accounts for 0.2% of the original kidney diseases of dialysis patients in Japan. However, the number of patients with renal amyloidosis seems to be increasing in recent years. There have been some new concepts focusing on the mechanism of amyloidogenesis, such as molecular chaperones, seeding mechanism, and genetic polymorphisms of precursor protein. Clinical and histological features of renal amyloidosis vary according to the type. Significantly higher levels of urinary protein excretion are seen in the AL type, whereas microscopic haematuria is more prominent in the AA type. Histologically, amyloid deposition of AL type has stronger predilection for GBM than mesangium, and spicule formation is more frequently observed. In contrast, AA type has a higher affinity to TBM and interstitial area. For the histological diagnosis of renal amyloidosis, plural staining methods including Congo-red, Daylon and thioflavin-T stains are available. Combinations of these staining methods are necessary for establishing the precise diagnosis. The more recent and intensive treatments for renal amyloidosis are expected to improve patient outcome. For AL amyloidosis, high-dose melphalan plus high-dose dexamethasone or VAD, in conjunction with bone marrow stem cells transplantation, have shown a definitive effect on reducing urinary protein excretion. The biological agent, tumor necrosis factor (TNF alpha) blocker, improves the renal function in AA-type renal amyloidosis, as well as suppresses the inflammatory reactions in patients with rheumatoid arthritis. Clinical advances have been made in various aspects of renal amyloidosis.

show abstract

Section: Clinical Diagnosis and Clinical Features Of Renal Amyloidosismentioning

confidence: 99%

New advances in renal amyloidosis

et al. 2008

Self Cite

View full text Add to dashboard Cite

show abstract

“…Several outcome studies have discussed the onset and progressive mechanisms of renal amyloidosis; however, detailed analyses of a large number of cases have not been undertaken (1)(2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

Prognostic Factors for Renal Amyloidosis:A Clinicopathological Study Using Cluster Analysis

et al. 2007

View full text Add to dashboard Cite

show abstract

“…A large cohort of Chinese patients with renal amyloid light-chain amyloidosis study revealed that the degree of amyloid deposition in glomeruli was closely associated with proteinuria and renal function, higher vascular deposition of amyloid was associated with milder proteinuria, but not associated with renal insufficiency [10] . Osawa et al [19] reported that patients with renal amyloidosis with interstitial damage in the kidney had marked poorer prognosis than those without such damage. In addition, Yao et al [10] found that advanced glomerular deposition, interstitium amyloid deposition, inflammatory infiltration and existence of casts in tubules were all associated with renal insufficiency.…”

Section: Discussionmentioning

confidence: 98%

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

Chen

Zhang

et al. 2015

J. Huazhong Univ. Sci. Technol. [Med. Sci.]

View full text Add to dashboard Cite

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.

show abstract

Renal function at the time of renal biopsy as a predictor of prognosis in patients with primary AL-type amyloidosis

Abstract: Our study demonstrated that renal function at the time of biopsy and renal interstitial damage are the best predictors of survival in AL-type renal amyloidosis.

Cited by 15 publications

References 24 publications

New advances in renal amyloidosis

New advances in renal amyloidosis

Prognostic Factors for Renal Amyloidosis:A Clinicopathological Study Using Cluster Analysis

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

Contact Info

Product

Resources

About