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Q J Med 2000; 93: 535-542
© 2000 Association of Physicians

Presentation, survival and prognostic markers in AA amyloidosis

N. Joss, K. McLaughlin, K. Simpson and J.M. Boulton-Jones

From the Renal Unit, Glasgow Royal Infirmary, Glasgow, UK

Received 5 May 2000 and in revised form 13 June 2000

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. (r2=40%, p=0.001)

Address correspondence to Dr N. Joss, Renal Unit, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF


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