PMID- 17329915
OWN - NLM
STAT- MEDLINE
DCOM- 20070409
LR  - 20190606
IS  - 1349-7235 (Electronic)
IS  - 0918-2918 (Linking)
VI  - 46
IP  - 5
DP  - 2007
TI  - Prognostic factors for renal amyloidosis: a clinicopathological study using 
      cluster analysis.
PG  - 213-9
AB  - 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.
FAU - Sasatomi, Yoshie
AU  - Sasatomi Y
AD  - Division of Nephrology & Rheumatology, Department of Internal Medicine, Fukuoka 
      University School of Medicine, Fukuoka, Japan. sasatomi@fukuoka-u.ac.jp
FAU - Sato, Hiroshi
AU  - Sato H
FAU - Chiba, Yoshiro
AU  - Chiba Y
FAU - Abe, Yasuhiro
AU  - Abe Y
FAU - Takeda, Seiji
AU  - Takeda S
FAU - Ogahara, Satoru
AU  - Ogahara S
FAU - Murata, Toshiaki
AU  - Murata T
FAU - Kaneoka, Hidetoshi
AU  - Kaneoka H
FAU - Takebayashi, Shigeo
AU  - Takebayashi S
FAU - Iwasaki, Hiroshi
AU  - Iwasaki H
FAU - Saito, Takao
AU  - Saito T
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20070301
PL  - Japan
TA  - Intern Med
JT  - Internal medicine (Tokyo, Japan)
JID - 9204241
RN  - 0 (Amyloid)
RN  - 0 (Serum Amyloid A Protein)
RN  - 0 (amyloid L, human)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Amyloid/metabolism
MH  - Amyloidosis/complications/*pathology/*physiopathology
MH  - Blood Vessels/pathology
MH  - Cluster Analysis
MH  - Creatinine/blood
MH  - Disease Progression
MH  - Female
MH  - Heart/physiopathology
MH  - Humans
MH  - Kidney/blood supply/metabolism/pathology
MH  - Kidney Diseases/complications/*pathology/*physiopathology
MH  - Kidney Tubules/pathology
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Nephrotic Syndrome/complications/physiopathology
MH  - Prognosis
MH  - Proteinuria/complications/physiopathology
MH  - Serum Amyloid A Protein/metabolism
MH  - Severity of Illness Index
MH  - Survival Analysis
EDAT- 2007/03/03 09:00
MHDA- 2007/04/10 09:00
CRDT- 2007/03/03 09:00
PHST- 2007/03/03 09:00 [pubmed]
PHST- 2007/04/10 09:00 [medline]
PHST- 2007/03/03 09:00 [entrez]
AID - JST.JSTAGE/internalmedicine/46.1690 [pii]
AID - 10.2169/internalmedicine.46.1690 [doi]
PST - ppublish
SO  - Intern Med. 2007;46(5):213-9. doi: 10.2169/internalmedicine.46.1690. Epub 2007 
      Mar 1.