Renal amyloidosis

Sasaki, Hideo; Shimokama, Tatsuro; Yoshikawa, Yutaka; Toyoshima, Hazime; Kitamoto, Tetsuyuki; Watanabe, Teruo

doi:10.1007/bf00737143

Cited by 44 publications

(9 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is thought that amyloid deposition accelerates renal dysfunction [3, 13, 14]. Renal biopsy of patients with renal dysfunction showed that when total tubulointerstitial and vascular damage exceeded 4 points, renal damage was severe (table 4).…”

Section: Discussionmentioning

confidence: 99%

“…Severe proteinuria and nephrotic syndrome are strongly related to the amount and pattern of amyloid deposition [13, 20]. Bohle et al [3]reported that tubulointerstitial damage in renal amyloidosis, especially interstitial fibrosis, was an important finding determining renal prognosis.…”

Section: Discussionmentioning

confidence: 99%

“…Amyloid AL was also seen in combination with the nephrotic syndrome. Shiiki et al [13]proposed that amyloid AL is characterized by deposition in the peribasement membrane. The deposition patterns of amyloid AA and AL in renal tissue were unique to each type in our study.…”

Section: Discussionmentioning

confidence: 99%

“…S-Cr levels (normal <2.0 mg/dl) at biopsy were important prognostic markers of impending renal death. Some reports have claimed that renal failure or renal dysfunction in cases of AA amyloidosis are more frequent than AL amyloidosis [13, 14]. …”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Prognosis of Renal Amyloidosis: A Clinicopathological Study Using Cluster Analysis

Sasatomi

Kiyoshi²,

Uesugi³

et al. 2001

Nephron

View full text Add to dashboard Cite

Progression of renal amyloidosis is associated with severe proteinuria or nephrotic syndrome, and various mechanisms have been postulated to explain these complications. We studied the acceleration of proteinuria and reduced renal function by cluster analysis using clinical parameters, renal histological findings, type of renal amyloidosis and follow-up data. We divided 97 cases into three groups of renal amyloidosis. Accelerated progression correlated with serum creatinine (s-Cr) levels at renal biopsy and histological grade of renal damage by amyloid deposition (p < 0.0001). The most influential prognostic factors (s-Cr level ≧2.0 mg/dl) were tubulointerstitial and vascular damage induced by amyloid deposition at biopsy (odds ratio 96.9 and 69.2, respectively). In addition, we found amyloidosis type amyloid associated (AA) correlated with more amyloid-mediated vascular and tubulointerstitial damage than amyloidosis type amyloid light chain (AL) (p < 0.001, p < 0.01, respectively). Proteinuria and nephrotic syndrome were more severe in cases of amyloidosis AL than in amyloidosis AA (p = 0.076). In conclusion, less tubulointerstitial and vascular damage was caused by amyloid deposition; this was slowly progressive. Amyloid AA was detected in tubulointerstitial tissue and vessels more frequently than amyloid AL. Heavy proteinuria and/or nephrosis were not indicators of rapid progression.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Prognosis of Renal Amyloidosis: A Clinicopathological Study Using Cluster Analysis

Sasatomi

Kiyoshi²,

Uesugi³

et al. 2001

Nephron

View full text Add to dashboard Cite

show abstract

“…Second, the renal location of the amyloid deposition might be different in our patient and the previously reported patients. The clinical presentation and prognosis of renal AA amyloidosis were reportedly associated with whether the amyloid deposited predominantly in the glomeruli or in the vessels [15, 16]. Moreover, therapeutic response of DMARDs may vary among different renal cell types in patients with AA amyloidosis.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic Benefits of Tocilizumab Vary in Different Organs of a Patient with AA Amyloidosis

Matsui

Okayama

Tsushima

et al. 2014

Case Reports in Nephrology

View full text Add to dashboard Cite

Systemic reactive AA amyloidosis is a life-threatening complication of chronic inflammatory diseases. Anti-interleukin-6 receptor, tocilizumab (TCZ), has been shown to improve clinical symptoms of patients with AA amyloidosis, accompanied with regression of the amyloid deposition. We report a case of AA amyloidosis evaluated by histology of multiple organs before and after TCZ treatment. A woman in her 60s with rheumatoid arthritis was referred to our hospital because of cardiac and renal dysfunction. A gastric and renal biopsy revealed the deposition of AA amyloid, and echocardiography revealed concentric left ventricular hypertrophy. Her estimated glomerular filtration rate was decreased to 8.6 mL/min/1.73 m2, and B-type natriuretic peptide, C-reactive protein, and serum amyloid A protein were significantly elevated. TCZ treatments markedly decreased her serum amyloid A protein and C-reactive protein levels, but hemodialysis was required 1 year later. Endoscopic gastric rebiopsy 3 years after initiation of TCZ treatments revealed the regression of amyloid deposition and echocardiography revealed improvement of her left ventricular hypertrophy. However, a renal rebiopsy revealed that the amyloid deposition had not regressed. In conclusion, these observations suggest that the therapeutic effects of TCZ can vary among organs in patients with AA amyloidosis.

show abstract

Development of nodular lesions in amyloidosis with reference to diabetic nephropathy

1997

View full text Add to dashboard Cite

Background: One characteristic histologic change in diabetic glomerulopathy is nodular and diffuse mesangial expansion, which resembles the alterations seen in renal amyloidosis. We addressed the questions of whether the morphologic changes seen in renal amyloidosis are related to the biochemical amyloid type, and whether there is a histologic analogy in diabetic glomerulopathy. Methods: We examined kidney specimens obtained from autopsies on 30 patients with systemic amyloidosis and 34 with diabetes mellitus. Results: The mean age at death of the patients with amyloidosis was 60.6 + 10.9 years. All samples were positively stained by Congo red and direct fast scarlet stains. All nonnephrotic patients showed minimal diffuse or nodular lesions. Most of the lesions found in the patients with nephrosis were severe. We also assessed the histologic glomerular changes in 34 cases of diabetes mellitus. The mean age at death of the patients in this group was 62.3 _+ 12.3 years. In diabetic nephropathy, severe nodular lesions did not appear until there was progression of diffuse lesions. By contrast, in the amyloid kidney, nodular mesangial expansion could be seen in glomeruli even when the diffuse mesangial expansion was slight. Conclusions" There is no significant relationship between histologic amyloid deposition patterns and biochemical amyloid types. Although, in both diabetic nephropathy and renal amyloidosis, the histologic alterations of the kidneys include diffuse and nodular mesangial expansion, these alterations progress separately in amyloidosis, while in diabetic nephropathy, the nodular lesions appear after progression of diffuse mesangial thickening.

show abstract

Renal amyloidosis

Cited by 44 publications

References 13 publications

Prognosis of Renal Amyloidosis: A Clinicopathological Study Using Cluster Analysis

Prognosis of Renal Amyloidosis: A Clinicopathological Study Using Cluster Analysis

Therapeutic Benefits of Tocilizumab Vary in Different Organs of a Patient with AA Amyloidosis

Development of nodular lesions in amyloidosis with reference to diabetic nephropathy

Contact Info

Product

Resources

About