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.
Verfasserangaben: | Oliver Jung, Hans Stefan Haack, Maike Büttner, Christoph Betz, Christoph StephanORCiDGND, Peter Grützmacher, Kerstin Ute Amann, Markus BickelGND |
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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 |
Titel des übergeordneten Werkes (Englisch): | BMC nephrology |
Verlag: | BioMed Central |
Verlagsort: | London |
Dokumentart: | Wissenschaftlicher Artikel |
Sprache: | Englisch |
Jahr der Fertigstellung: | 2012 |
Datum der Erstveröffentlichung: | 21.11.2012 |
Veröffentlichende Institution: | Universitätsbibliothek Johann Christian Senckenberg |
Datum der Freischaltung: | 17.12.2012 |
Freies Schlagwort / Tag: | AA-amylodosis; Chronic kidney disease; HIV; IVDU |
Jahrgang: | 13 |
Ausgabe / Heft: | 151 |
Seitenzahl: | 7 |
HeBIS-PPN: | 319117529 |
Institute: | Medizin / Medizin |
DDC-Klassifikation: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
Sammlungen: | Universitätspublikationen |
Lizenz (Deutsch): | ![]() |