期刊论文详细信息
BMC Nephrology
Significant association between renal function and amyloid-positive area in renal biopsy specimens in AL amyloidosis
Ichiei Narita1  Masaaki Nakano3  Shuichi Murakami1  Yoko Wada1  Daisuke Kobayashi1  Naohito Tanabe2  Takeshi Kuroda1 
[1] Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-ku, Niigata City, 951-8510, Japan;Department of Health and Nutrition, Faculty of Human Life Studies, University of Niigata Prefecture, 471 Ebigase, Higashi-ku, Niigata, 950-8680, Japan;Department of Medical Technology, School of Health Sciences, Faculty of Medicine, Niigata University, 2-746 Asahimachi-Dori, Chuo-ku, Niigata City, 951-8518, Japan
关键词: Renal function;    Estimated GFR;    Creatinine clearance;    Amyloid-positive area;    AL amyloidosis;   
Others  :  1083093
DOI  :  10.1186/1471-2369-13-118
 received in 2012-06-14, accepted in 2012-09-17,  发布年份 2012
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【 摘 要 】

Background

The kidney is a major target organ for systemic amyloidosis that often affects the kidney including proteinura, and elevated serum creatinine (Cr). The correlation between amount of amyloid deposits and clinical parameters is not known. The aim of this study was to clarify correlation the amyloid area in all renal biopsy specimen and clinical parameters.

Methods

Fifty-eight patients with an established diagnosis of AL amyloidosis participated in the study. All patients showed amyloid deposits in renal biopsies. We retrospectively investigated the correlation between clinical data and amyloid occupied area in whole renal biopsy specimens.

Results

The area occupied by amyloid was less than 10% in 57 of the 58 patients, and was under 2% in 40. For statistical analyses, %amyloid-positive areas were transformed to common logarithmic values (Log10%amyloid). Cr showed significant correlation with Log10%amyloid and estimated glomerular filtration rate (eGFR) showed the significant negative correlation. Patient age, cleatinine clearance (Ccr), blood urea nitorogen, and urinary protein was not significantly correlated with Log10%amyloid. The correlation with other clinical factors such as sex, and serum concentrations of total protein, albumin, immunoglobulins, compliments was evaluated. None of these factors significantly correlated with Log10%amyloid. According to sex- and age- adjusted multiple linear regression analysis, Log10%amyloid had significant positive association with Cr and significant negative association with eGFR.

Conclusion

There is significant association between amyloid-positive area in renal tissue and renal function, especially Cr and eGFR. The level of Cr and eGFR may be a marker of amount of amyloid in renal tissue.

【 授权许可】

   
2012 Kuroda et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Husby G: Nomenclature and classification of amyloid and amyloidosis. J Intern Med 1992, 232:511-512.
  • [2]Falk RH, Comenzo RL, Skinner M: The systemic amyloidosis. N Engl J Med 1997, 337:898-909.
  • [3]Kingman A, Pereira NL: Cardiac amyloidosis. JS C Med Assoc 2001, 97:201-206.
  • [4]Kelly JJ: Neurologic complications of primary systemic amyloidosis. Rev Neurol Dis 2006, 3:173-181.
  • [5]Nestle FO, Burg G: Bilateral carpal tunnel syndrome as a clue for the diagnosis of systemic amyloidosis. Dermatology 2001, 202:353-355.
  • [6]Alhaddab M, Srolovitz H, Rosen N: Primary systemic amyloidosis presenting as extensive cutaneous ulceration. J Cutan Med Surg 2006, 10:253-256.
  • [7]Kyle RA: Plasma cell disorderes. In Cecil textbook of medicine 21st edition. Edited by Glodman L, Bennett JC. 2000, 977-987.
  • [8]Kyle RA, Wagoner RD, Holley KE: Primary systemic amyloidosis: resolution of the nephrotic syndrome with melphalan and prednisone. Arch Intern Med 1982, 142:1445-1447.
  • [9]Goddard IR, Jackson R, Jones JM: AL amyloidosis: therapeutic response in two patients with renal involvement. Nephrol Dial Transplant 1991, 6:592-594.
  • [10]Kyle RA, Gertz MA, Greipp PR, Witzig TE, Lust JA, Lacy MQ, Therneau TM: A trial of three regimens for primary amyloidosis: colchicines alone, melphalan and prednisone, and melphalan, prednisone, and colchicine. N Engl J Med 1997, 336:1202-1207.
  • [11]Gertz MA, Leung N, Lacy MQ, Dispenzieri A, Zeldenrust SR, Hayman SR, Buadi FK, Dingli D, Greipp PR, Kumar SK, Lust JA, Rajkumar SV, Russell SJ, Witzig TE: Clinical outcome of immunogloburin light chain amyloidosis affecting the kidney. Nephrol Dial Transplant 2009, 24:3132-3137.
  • [12]Sen S, Sarsik B: A proposed histopathologic classification, scoring, and grading system for renal amyloidosis: standardization of renal amyloid biopsy report. Arch Pathol Lab Med 2010, 134:532-544.
  • [13]Imai E, Horio M, Nitta K, Yamagata K, Iseki K, Tsukamoto Y, Ito S, Makino H, Hishida A, Matsuo S: Modification of the modification of diet in renal disease (MDRD) study equation for Japan. Am J Kidney Dis 2007, 50:927-937.
  • [14]Kuroda T, Tanabe N, Kobayashi D, Wada Y, Murakami S, Nakano M, Narita I: Significant association between renal function and area of amyloid deposition in kidney biopsy specimens in reactive amyloidosis associated with rheumatoid arthritis. Rheumatol Int 2011.
  • [15]Kyle RA, Gertz MA: Primary systemic amyloidosis: clinical and laboratory features in 474 cases. Semin Hematol 1995, 32:45-59.
  • [16]Bohle A, Wehrmann M, Eissele R, Gise HV, Mackensen-Haen S, Muller C: The long-term prognosis of AA and AL renal amyloidosis and the pathogenesis of chronic renal failure in renal amyloidosis. Pathol Res Pract 1993, 189:316-331.
  • [17]Sasatomi Y, Kiyoshi Y, Uesugi N, Hisano S, Takebayashi S: Prognosis of renal amyloidosis: a clinicopathological study using cluster analysis. Nephron 2001, 87:42-49.
  • [18]Osawa Y, Kawamura K, Kondo D, Imai N, Ueno M, Nishi S, Iino N, Okada M, Suzuki Y, Hoshino S, Yamazaki H, Kishimoto H, Shimada H, Yamagishi T, Ishiyama T, Narita I, Gejyo F: Renal function at the time of renal biopsy as a predictor of prognosis in patients with primary AL-amyloidosis. Clin Exp Nephrol 2004, 8:127-133.
  • [19]Ogg CS, Cameron JS, Williams DG, Turner DR: Presentation and course of primary amyloidosis of the kidney. Clin Nephrol 1981, 15:9-13.
  • [20]Watanabe T, Saniter T: Morphological and clinical features of renal amyloidosis. Virchows Arch 1975, 366:125-135.
  • [21]Dikman SH, Churg J, Kahn T: Morphological and clinical correlates in renal amyloidosis. Human Pathol 1981, 12:360-369.
  • [22]Shemesh O, Golbetz H, Kriss JP, Mayer BD: Limitation of creatinine as a filtration marker in glomerulopathic patients. Kidney Int 1985, 28:830-838.
  • [23]Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, Yamagata K, Tomino Y, Yokoyama H, Hishida A: Collaborators developing the Japanese equation for estimated GFR. Rivised equation for estimated GFR from serum creatinine crearance in Japan. Am J Kid Dis 2009, 53:982-992.
  • [24]Kuroda T, Wada Y, Kobayashi D, Murakami S, Sakai T, Hirose S, Tanabe N, Saeki T, Nakano M, Narita I: Effective anti-TNF-α therapy can Induce rapid resolution and sustained decrease of gastroduodenal mucosal amyloid deposits in reactive amyloidosis associated with rheumatoid arthritis. J Rheumatol 2009, 36:2409-2415.
  • [25]Bergesio F, Ciciani AM, Manganaro M, Palladini G, Santostefano M, Brugnano R, Di Palma AM, Gallo M, Rosati A, Tosi PL, Salvadori M: Immunopathology group of the Italian society of nephrology. Renal involvement in systemic amyloidosis. Nephrol Dial Transplant 2008, 23:941-951.
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