Presentation, survival and prognostic markers in AA amyloidosis

QJM. 2000 Aug;93(8):535-42. doi: 10.1093/qjmed/93.8.535.

Abstract

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)

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Albuminuria / etiology
  • Amyloidosis / blood*
  • Amyloidosis / mortality
  • Amyloidosis / therapy
  • C-Reactive Protein / analysis
  • Cause of Death
  • Creatinine / blood
  • Disease-Free Survival
  • Female
  • Humans
  • Kidney Diseases / blood*
  • Kidney Diseases / mortality
  • Kidney Diseases / therapy
  • Male
  • Middle Aged
  • Prognosis
  • Regression Analysis
  • Renal Replacement Therapy
  • Retrospective Studies
  • Serum Albumin / analysis
  • Serum Amyloid A Protein / metabolism*

Substances

  • Serum Albumin
  • Serum Amyloid A Protein
  • C-Reactive Protein
  • Creatinine