TY  - JOUR
A1  - Jung, Oliver
A1  - Haack, Hans Stefan
A1  - Büttner, Maike
A1  - Betz, Christoph
A1  - Stephan, Christoph
A1  - Grützmacher, Peter
A1  - Amann, Kerstin Ute
A1  - Bickel, Markus
T1  - Renal AA-amyloidosis in intravenous drug users - a role for HIV-infection?
T2  - BMC nephrology
N2  - 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.
KW  - AA-amylodosis
KW  - IVDU
KW  - Chronic kidney disease
KW  - HIV
Y1  - 2012
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/27543
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-275438
SN  - 1471-2369
VL  - 13
IS  - 151
PB  - BioMed Central
CY  - London
ER  -