Renal AA-amyloidosis in intravenous drug users - a role for HIV-infection?

  • Background: Chronic renal disease is a serious complication of long-term intravenous drug use (IVDU). Recent reports have postulated a changing pattern of underlying nephropathy over the last decades. Methods: Retrospective investigation including all patients with prior or present IVDU that underwent renal biopsy because of chronic kidney disease between 01.04.2002 and 31.03.2012 in the city of Frankfurt/Main, Germany. Results: Twenty four patients with IVDU underwent renal biopsy because of progressive chronic kidney disease or proteinuria. Renal AA-amyloidosis was the predominant cause of renal failure in 50% of patients. Membranoproliferative glomerulonephritis (GN) was the second most common cause found in 21%. Patients with AA-amyloidosis were more likely to be HIV infected (67 vs.17%; p=0.036) and tended to have a higher rate of repeated systemic infections (92 vs. 50%; p=0.069). Patients with AA-amyloidosis presented with progressive renal disease and nephrotic-range proteinuria but most patients had no peripheral edema or systemic hypertension. Development of proteinuria preceded the decline of GFR for approximately 1--2 years. Conclusions: AA-amyloidosis was the predominant cause of progressive renal disease in the last 10 years in patients with IVDU. The highest rate of AA-amyloidosis observed was seen in HIV infected patients with IVDU. We speculate that chronic HIV-infection as well as the associated immunosuppression might promote development of AA-amyloidosis by increasing frequency and duration of infections acquired by IVDU.

Download full text files

Export metadata

Additional Services

Share in Twitter Search Google Scholar
Metadaten
Author:Oliver Jung, Hans Stefan Haack, Maike Büttner, Christoph Betz, Christoph StephanORCiDGND, Peter Grützmacher, Kerstin Ute Amann, Markus Bickel
URN:urn:nbn:de:hebis:30:3-275438
DOI:https://doi.org/10.1186/1471-2369-13-151
ISSN:1471-2369
Pubmed Id:https://pubmed.ncbi.nlm.nih.gov/23171281
Parent Title (English):BMC nephrology
Publisher:BioMed Central
Place of publication:London
Document Type:Article
Language:English
Year of Completion:2012
Date of first Publication:2012/11/21
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2012/12/17
Tag:AA-amylodosis; Chronic kidney disease; HIV; IVDU
Volume:13
Issue:151
Page Number:7
HeBIS-PPN:319117529
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (German):License LogoCreative Commons - Namensnennung 2.0