Vol 9, No 3 (2018)
Review paper
Published online: 2018-10-17

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Renal amyloidosis

Wojciech Wołyniec12, Agnieszka Perkowska-Ptasińska1, Alicja Dębska-Ślizień3, Tomasz Liberek3, Magdalena Durlik1
Hematologia 2018;9(3):208-221.


Kidney amyloid deposition is one of the most common and most severe manifestations of systemic amyloidosis. Since kidney involvement occurs in almost each type of amyloidosis, proteinuria and GFR (glomerular filtration rate) decrease are often among the first symptoms of this disease. Kidney involvement is, beside heart failure, a major prognostic factor. The most typical presentation is isolated nephrotic syndrome, especially in two most common types of the disease: AA and AL amyloidoses. The less common manifestation is chronic renal failure, which typically occurs in the acquired types of amyloidosis (ALECT2, AApoAIV), but also in several hereditary genetic forms. In the case of renal involvement, kidney biopsy is of major significance: it allows not only for amyloidosis recognition, but also for further specification of its type. Currently there are methods allowing for reduction in the amyloidogenic protein release and amyloid deposition, also in kidney tissue. Due to the effective treatment, proteinuria reduction and slowdown of kidney failure progression became possible. In the case of the successful control of amyloid production, patients with end-stage renal failure can be qualified for kidney transplantation.

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