| Prognostic factors for renal amyloidosis: a clinicopathological study using cluster analysis. | |
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MedLine Citation:
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PMID: 17329915 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: There is no standardized therapy for renal amyloidosis, which shows rapid progression and poor prognosis. Here, we used cluster analysis to examine the correlation between amyloid-related renal damage and prognosis, and determined the clinicopathological prognostic factors for renal amyloidosis. METHODS AND PATIENTS: We analyzed 125 patients with renal amyloidosis (men/women: 43/82; mean age at renal biopsy: 58.8+/-11.1 years, +/-SD; range: 21-78 years). Cluster analysis was performed using clinical parameters, renal histological findings, type of renal amyloidosis, and follow-up data. We also analyzed survival data. RESULTS: We divided 125 cases (prognosis was checked in 97 [77.6%] cases) into three groups by cluster analysis. In the cluster groups, 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 important prognostic factors were glomerular, tubulointerstitial, and vascular lesions induced by amyloid deposition at biopsy (p<0.0001). We also found that amyloid-A (AA) type amyloidosis correlated is more significantly with amyloid-mediated vascular (P=0.0010) and tubulointerstitial lesions (p=0.0705) than with amyloid-L (AL) type amyloidosis. Proteinuria and nephrotic syndrome were more severe in AL than AA amyloidosis (p=0.0836). The 10-year individual survival rate was about 20%, and most deaths were due to cardiovascular disease and infection. CONCLUSION: Our results indicate that the quantity of amyloid deposition in the kidney, and the extent of glomerular, tubulointerstitial, and vascular damage are significant renal prognostic factors in amyloidosis. |
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Authors:
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Yoshie Sasatomi; Hiroshi Sato; Yoshiro Chiba; Yasuhiro Abe; Seiji Takeda; Satoru Ogahara; Toshiaki Murata; Hidetoshi Kaneoka; Shigeo Takebayashi; Hiroshi Iwasaki; Takao Saito |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't Date: 2007-03-01 |
Journal Detail:
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Title: Internal medicine (Tokyo, Japan) Volume: 46 ISSN: 1349-7235 ISO Abbreviation: Intern. Med. Publication Date: 2007 |
Date Detail:
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Created Date: 2007-03-01 Completed Date: 2007-04-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9204241 Medline TA: Intern Med Country: Japan |
Other Details:
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Languages: eng Pagination: 213-9 Citation Subset: IM |
Affiliation:
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Division of Nephrology & Rheumatology, Department of Internal Medicine, Fukuoka University School of Medicine, Fukuoka, Japan. sasatomi@fukuoka-u.ac.jp |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Amyloid / metabolism Amyloidosis / complications, pathology*, physiopathology* Blood Vessels / pathology Cluster Analysis Creatinine / blood Disease Progression Female Heart / physiopathology Humans Kidney / blood supply, metabolism, pathology Kidney Diseases / complications, pathology*, physiopathology* Kidney Tubules / pathology Male Middle Aged Multivariate Analysis Nephrotic Syndrome / complications, physiopathology Prognosis Proteinuria / complications, physiopathology Serum Amyloid A Protein / metabolism Severity of Illness Index Survival Analysis |
| Chemical | |
Reg. No./Substance:
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0/Amyloid; 0/Serum Amyloid A Protein; 0/amyloid L, human; 60-27-5/Creatinine |
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