Pathological, Clinical Characteristics and Prognostic Analysis of Amyloid Nephropathy

Abstract

Background: The number of patients diagnosed with renal amyloidosis is increasing year by year, and the pathological grade and prognostic factors are not clear. This study attempts to investigate the pathological features of renal amyloidosis and the prognostic factors in patients with amyloidosis. Method：To evaluate the pathological sections of 184 patients with renal amyloidosis in the Department of Pathology, Shandong University, and to retrospectively analyze the clinical data of 175 patients with amyloidosis in our center and to follow up them. Results: There was a positive correlation between different pathological grades and creatinine levels (rs = 0.275, P = 0.38), the higher the pathological grade, the higher the incidence of renal insufficiency (χ2 = 8.44, P = 0.015); the more severe the tubulointerstitial damage, the higher the incidence of renal insufficiency (χ2 = 14.15, P = 0.007); different degrees of tubulointerstitial damage and glomerulosclerosis affected the urinary protein quantification, and the difference was statistically significant (P < 0.05). The treatment effect of older is worse (P=0.030，OR=1.040，95%CI=1.004，1.078) and the effect of selecting an effective treatment is better (P = 0.002, OR = 0.618, 95% CI = 0.456, 0.839). Hypotension, cardiac involvement, decreased serum albumin, and increased TnT were independent risk factors for survival; while receiving effective treatment modalities was an independent protective factor.Conclusion: The pathological grade of renal amyloidosis is associated with the incidence of renal insufficiency, in which the degree of tubulointerstitial chronic lesions significantly affects renal function.