Presentation, survival and prognostic markers in AA amyloidosis.
We reviewed 43 patients with AA amyloidosis who presented to our unit between 1985-1999: 70% had an underlying chronic rheumatological diagnosis. Median (95% CI) patient survival from time of diagnosis was 52.9 months (9.4-96.6) and median renal survival was 18 months (3.2-32.8) Twenty-four patients have died; 42% of deaths were due to infection, while renal failure accounted for 12.5%. Presenting factors which adversely influenced outcome were a low serum albumin and a high 24-h urinary albumin excretion (p=0.007 and p=0.003, respectively). Stepwise multivariate regression analysis identified albuminuria and presenting creatinine clearance as significant predictors. (p=0.005 and p=0.035, respectively). Mean C-reactive protein (CRP) throughout follow-up correlated weakly but not significantly with survival off dialysis (p=0.06). Change in creatinine clearance correlated with albuminuria. (r(2)=40%, p=0.001)
Joss
N
N
Renal Unit, Glasgow Royal Infirmary, Glasgow, UK.
McLaughlin
K
K
Simpson
K
K
Boulton-Jones
J M
JM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000209:etiology; D000686:Amyloidosis / Q000097:blood* / Q000401:mortality / Q000628:therapy; D002097:C-Reactive Protein / Q000032:analysis; D002423:Cause of Death; D003404:Creatinine / Q000097:blood; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000097:blood* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012044:Regression Analysis; D017582:Renal Replacement Therapy; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis; D000685:Serum Amyloid A Protein / Q000378:metabolism*
D012709:Serum Albumin; D000685:Serum Amyloid A Protein; D002097:C-Reactive Protein; D003404:Creatinine