[Renal amyloidoses in nephrology].

Abstract

The purpose of this study was to investigate the epidemiological, evolutionary and clinical features of the renal amyloidosis and to identify poor prognostic factors. We conducted a retrospective study focusing on all patients hospitalized for renal amyloidosis between January 2013 and December 2014. The diagnosis was confirmed by renal puncture-biopsy or by biopsy of minor salivary glands. We collected data from 25 patients, 17 men and eight women, with an average age of 47.2 ± 18 years. Hospitalization rate and prevalence were 2.4% and 12.5 cases/year respectively. On admission, nephrotic syndrome was detected in 100% of cases and renal failure in 68% of cases. Proteinuria was ≥6g/24h in 60% of cases. Digestive symptoms (n=14), cardiac symptoms (n=10) and arterial hypotension (n=11) were the other manifestations. Infectious and inflammatory diseases were the main causes found (60%). Tuberculosis alone accounted for 20%. After a mean follow-up period of 219.5 days, chronic renal failure was found in 16 cases (64%), including 11 cases with end-stage disease (44%). Six patients died. Renal insufficiency at the time of diagnosis, the worsening of renal function and readmission were associated with a risk for chronic terminal renal failure (p: 0.03-0.04). Cardiac damage, the readmission and proteinuria ≥6g/24h were factors associated with the risk of mortality (p< 0.03). Renal failure, cardiac damage, proteinuria ≥6g/24h and readmission were the main factors for poor prognosis in this cohort.