SURVIVAL ANALYSIS OF PATIENTS WITH PRIMARY RENAL AMYLOIDOSIS

Introduction:

Currently, there is no National Consensus on the treatment of renal amyloidosis in the Republic of Belarus. The aim of the study was to investigate the clinical outcome of patients with histopathologic diagnosis of renal amyloidosis according to the data of nephrobiopsies performed fro period 2012-2024 in city Minsk, Republic of Belarus

Methods:

A retrospective analysis of histopathologic reports of renal biopsies performed in the Minsk City Clinical Pathology Bureau for the period from 2012 to 2024 was performed. The inclusion criteria for the study were the age of patients older than 18 years, presence of histopathologic diagnosis of primary renal amyloidosis. Sex and age characteristics of the patients, treatment options (symptomatic or chemotherapy) were studied. The patient mortality was taken as the primary endpoints studied. The survival of the patients using the Kaplan-Meier method was evaluated.

Results:

1115 histopathological reports of renal biopsies were analyzed, from them 73  with the diagnosis of renal amyloidosis were singled out. Taking into account immunohistopathologic staining for AA-protein and standard immunofluorescence 3 groups of patients were distinguished: AA-amyloidosis (n=44), primary AL-amyloidosis (n=9) and primary non-AA-amyloidosis (n=20). In the next step, the sex and age characteristics of patients in the second and third groups (n=29) were studied. Of the 29 patients, 15 patients received symptomatic therapy and 14 patients received specific hemotherapy. Further 3 patients were excluded from the study due to a lack of cclinical information. The mean age of patients with primary amyloidosis was 58.4+-13.6 years, with a mean age of 62.1+-13.5 years in the symptomatic therapy group and 55.3+-13.4 years in the chemotherapy group, respectively. The sex ratio was 11 males and 15 females. ESRD developed in 5 patients during the observation period, which required the beginning of renal replacement therapy: 4 patients were on chronic  hemodialysis, 2 of them later underwent kidney transplantation from a cadaveric donor, and 1 patient received renal replacement therapy by peritoneal dialysis. Using the Kaplan-Meier method, it was evaluated five-year survival among the patients with primary amyloidosis (26 patients), dividing them into 2 subgroups: 1a-patients receiving symptomatic therapy, 2a-patients receiving specific therapy. Thus, in subgroup 1a the 5-year survival rate was 21,4%, and in subgroup 2a  40% respectively.

Conclusions:

This study revealed a number of following problems: low survival rate of the patients with primary amyloidosis, high rate of not complitely verified primary amyloidosis and low number of the patients who has been undergone specific chemotherapy.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.