Lessons from Four Decades of Systemic Amyloidosis with Renal Involvement

• Tipo: Artigo em Revista Científica Internacional
• Data: 2023

Autores

Oliveira-Silva, C (Autor) Outra; Marques, N (Autor) Outra; Pinho, A (Autor) Outra; Poínhos, Rui (Autor) FCNAUP; Bergantim, R (Autor) Outra; Nunes, AT (Autor) Outra; Sampaio, S (Autor) Outra; Rodrigues-Pereira, P (Autor) Outra; Silva, R (Autor) Outra; Praça, A (Autor) Outra; Frazão, J (Autor) Outra; Pestana, M (Autor) Outra; Tavares, I (Autor) FMUP

Revista

Título: Nephron

Vol. 147

Páginas: 158-169

ISSN: 1660-8151

Editora: Karger

Indexação

ISI Web of Knowledge - 1 Citação

Scopus - 2 Citações

Classificação Científica

CORDIS: Ciências da Saúde

FOS: Ciências médicas e da saúde

Outras Informações

ID Authenticus: P-00X-E01

DOI: 10.1159/000525675

Abstract (EN): Background: Apart from ATTR amyloidosis, the epidemiology and outcomes of the most common subtypes of systemic amyloidosis in Portugal remain primarily unknown. Methods: This retrospective cohort study evaluated patients with renal biopsy-proven amyloidosis, diagnosed from January 1978 to December 2019. Follow-up started at kidney disease presentation and ended at death or August 2020. Clinical presentation, survival, and prognostic factors were analysed. Results: Of 123 patients with amyloid nephropathy, 111 had definite amyloid typing and were analysed. AA amyloidosis was the most frequent type (56.1%) and was related mainly to chronic infection (47.8%) and chronic inflammatory arthritis (29.0%). AL amyloidosis was present in 25.2% of patients and hereditary forms in 6.5% (4.1% AFibE526V, 2.4% ATTRV30M). During follow-up, 73.9% of AA and 54.8% of AL patients progressed to end-stage renal disease, and 79.7% of AA and 77.4% of AL died; median overall survival was 66.0 (95% CI, 33.0-99.0) and 18.0 (95% CI, 9.3-26.7) months (p = 0.025), respectively. There were no significant differences in renal outcome and survival on dialysis between these two types. In multivariate analysis, cardiac involvement at presentation (HR 6.26 [95% CI, 2.89-13.56]) and estimated glomerular filtration rate <30 mL/min/1.73 m(2) (HR 2.05 [95% CI, 1.06-3.99]) independently influenced AA and AL amyloidosis survival. Cardiac involvement at presentation was an independent predictor of death (HR 9.65 [95% CI, 2.91-31.95]) and early mortality in AL amyloidosis. Conclusions: In Portugal, AA amyloidosis and related chronic infections are still relevant. Regarding AL amyloidosis, the low incidence and advanced disease at presentation result from missed and erroneous diagnoses, leading to delayed referrals and poor outcomes in these patients.

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 12