Kidney biopsy in AA amyloidosis: impact of histopathology on prognosis

In AA amyloidosis, while kidney biopsy is widely considered for diagnosis by clinicians, there is no evidence that the detailed investigation of renal histopathology can be utilized for the prognosis and clinical outcomes. In this study, we aimed to obtain whether histopathologic findings in kidney...

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Bibliographic Details
Published in:Amyloid 2017-07, Vol.24 (3), p.176-182
Main Authors: Kendi Celebi, Zeynep, Kiremitci, Saba, Ozturk, Bengi, Akturk, Serkan, Erdogmus, Siyar, Duman, Neval, Ates, Kenan, Erturk, Sehsuvar, Nergizoglu, Gokhan, Kutlay, Sim, Sengul, Sule, Ensari, Arzu, Keven, Kenan
Format: Article
Language:English
Subjects:
AA amyloidosis
Adult
Aged
Amyloid - metabolism
amyloid deposition pattern
Amyloidosis - diagnosis
Amyloidosis - metabolism
Amyloidosis - pathology
Biopsy
end-stage renal disease
Female
Glomerular Filtration Rate
Humans
Kidney Glomerulus - metabolism
Kidney Glomerulus - pathology
Male
Middle Aged
Prognosis
renal pathology
Retrospective Studies
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Summary:In AA amyloidosis, while kidney biopsy is widely considered for diagnosis by clinicians, there is no evidence that the detailed investigation of renal histopathology can be utilized for the prognosis and clinical outcomes. In this study, we aimed to obtain whether histopathologic findings in kidney biopsy of AA amyloidosis might have prognostic and clinical value. This is a retrospective cohort study that included 38 patients who were diagnosed with AA amyloidosis by kidney biopsy between 2005 and 2013.The kidney biopsy specimens of patients were evaluated and graded for several characteristics of histopathological lesions and their relationship with renal outcomes. Segmental amyloid deposition in the kidney biopsy was seen in 29%, global amyloid deposition in 71, diffuse involvement of glomeruli in 84.2%, focal involvement in 7%, glomerular enlargement in 53%, tubular atrophy in 75% and interstitial fibrosis in 78% of patients. Histopathologically, glomerular enlargement, interstitial fibrosis, tubular atrophy, interstitial inflammation and global amyloid deposition were significantly associated with lower estimated glomerular filtration rate (eGFR) (p = .02, p 
ISSN:1350-6129
1744-2818
DOI:10.1080/13506129.2017.1350158