The risk factors of chronic kidney disease progression in AA amyloidosis Renal outcome in AA amyloidosis

Aim: AA amyloidosis is a disease characterized by the accumulation of protofilaments in the extracellular space as a result of chronic inflammatory disease. The kidneys are the most affected organ. Although the prevalence has decreased due to the advances in treatments, the progression rate to end-stage renal disease (ESRD) is still high. The aim of this study was to determine the risk factors for the progression of chronic kidney disease (CKD) progression in patients with AA amyloidosis. Material and Methods: Fifty-six patients who were diagnosed with AA amyloidosis as a result of kidney biopsy were included in the study. Demographic features, laboratory data were recorded. Etiological reasons were noted as Familial Mediterranean Fever (FMF) and non-FMF disease. Patients were divided into two groups according to the annual decline of eGFR. Group I consisted of patients whose annual eGFR decline was more than 1ml/min/1,73m2 Results: The mean age of the patients was 51.12 +/- 14.5 years. The mean follow-up time was 3.72 +/- 3.57years. No difference was found between the two groups in terms of comorbid diseases, age, gender, mean blood pressure. eGFR at baseline was similar. In Group-I, non-FMF diseases were more, proteinuria in 24-hour urinalysis and CRP levels were high, and albumin was low. In regression analysis etiology, proteinuria, LDL-c/HDL-c ratio, platelet-lymphocyte ratio (PLR) are independent risk factors for the annual decline of eGFR. Discussion: Proteinuria, inflammation and dyslipidemia are important risk factors for CKD progression in AA amyloidosis. PLR is a simple and easy test that reflects inflammation in AA amyloidosis. It is beneficial to closely follow up amyloidosis cases caused by non-FMF disease, such as amyloidosis cases caused by FMF.