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Amyloidosis is a systemic disease that may affect the glomeruli of the kidneys. Amyloidosis itself is a disorder of protein metabolism characterised by the widespread deposition of abnormal protein strands throughout multiple organ systems of the body. The kidneys are commonly affected by this disorder.
Back topIn renal amyloidosis, malformed proteins are deposited in the kidneys, causing progressive kidney disease and kidney failure. There are more than 20 known proteins that can cause amyloidosis. All proteins have a three-dimensional structure that is dictated by chemical interactions between different amino acids in the protein chain. Abnormally structured protein will not perform its function in a normal way. Amyloidosis may occur when any factor causes one or several proteins fold incorrectly.
Risk Factors for Amyloid Nephropathy
The most important predisposing factor for the development of lupus nephritis is the presence of systemic amyloidosis. This may occur as a hereditary amyloid disorder or more frequently secondary to another medical condition such as certain infections, certain forms of cancer and long-term dialysis therapy for renal failure. A family history of amyloid disease is therefore an important risk factor of disease.
The presence of conditions causing secondary amyloidosis is also a predisposing factor for amyloid nephritis. These include:
Multiple myeloma and other malignancies;
Long-term infections such as tuberculosis, osteomyelitis and leprosy;
Chronic inflammatory disorders such as rheumatoid arthritis
Back topThe diagnosis of renal amyloidosis is usually made on exclusion of other important diagnoses such as glomerulonephritis and autoimmune diseases. A number of blood and urine tests may be performed to adequately exclude those conditions.
Back topProteinuria. Proteinuria is early manifestation of renal amyloidosis and may last for years.
Nephrotic Syndrome.
Renal insufficiency.
Renal interstitial-tubular nephritis, which causes symptoms including excessive urine output, increasing urine phosphate excretion, renal tubular acidosis, electrolyte disorders, etc.
Back topTreatments for renal amyloidosis mainly include the follows:
Specific treatment is adopted depending on the type of amyloidosis present: AL amyloidosis (associated to multiple myeloma)—chemocherapy against multiple myeloma AA amyloidosis (related to long-term of infections or inflammations)---treatment for infection or inflammation that has caused amyloidosis
Supportive treatment— Apply treatments for Nephrotic Syndrome or kidney failure based on the individualized condition. Patients with end-stage kidney failure may start dialysis to discharge metabolic wastes and reduce complications.
Blood purification technique
Treatment to repair damaged kidneys
Micro-Chinese Medicine Osmotherapy
Immunotherapy
Back topThe prognosis of renal amyloidosis is not good. The majority of patients will eventually develop into end-stage kidney failure, the rate of which depends on the type and severity of the disease as well as the effectiveness of treatment. The prognosis should also consider the damage of amyloidosis on other organs such as brain, liver, spleen, etc.
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