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Systemic Amyloidosis; Dialysis Article Summary

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Presentation and outcome of patients with systemic amyloidosis undergoing dialysis
Clinical Journal of the American Society of Nephrology, 04/09/08
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Bollee G et al. - Survival of patients with amyloidosis undergoing dialysis, especially Light chain (AL) type, is probably better than previously reported. However, mortality is higher in AL than secondary (AA) type, especially in the setting of cardiac involvement.

Methods
  • Aim was to obtain data regarding patients with AA or AL amyloidosis undergoing dialysis
  • Pts with AA or AL amyloidosis who started dialysis in 5 French centers between January 1, 1995 and December 31, 2005 were retrospectively studied

Results
  • 19 pts with AL and 20 pts with AA amyloidosis undergoing dialysis were identified
  • Pts with AL amyloidosis had shorter time from diagnosis to dialysis and more extrarenal amyloidosis, especially cardiac
  • Mean duration of f/u was 37.4 and 31.8 mo for pts with AL and AA amyloidosis, respectively
  • 78.9% of pts with AL and 15% with AA amyloidosis died on dialysis
  • Median survival was shorter in pts with AL than AA amyloidosis
  • Sepsis and cardiac deaths were the main causes of mortality
  • Prognosis factors for death at 1 yr were AL type, cardiac amyloidosis, heart failure and shorter time from diagnosis to dialysis
  • AL type, but not cardiac amyloidosis was independently associated with global mortality

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