Pattern of renal amyloidosis in South Africa

dc.contributor.authorHassen, Muhammeden_ZA
dc.contributor.authorBates, Williamen_ZA
dc.contributor.authorMoosa, Mohammed R.en_ZA
dc.identifier.citationHassen, M., Bates, W. & Moosa, M. R. 2019. Pattern of renal amyloidosis in South Africa. BMC Nephrology, 20:406, doi:10.1186/s12882-019-1601-x
dc.identifier.issn1471-2369 (online)
dc.descriptionCITATION: Hassen, M., Bates, W. & Moosa, M. R. 2019. Pattern of renal amyloidosis in South Africa. BMC Nephrology, 20:406, doi:10.1186/s12882-019-1601-x.
dc.descriptionThe original publication is available at
dc.description.abstractBackground: Kidney disease is a serious manifestation of systemic amyloidosis and a major cause of morbidity and mortality. Tuberculosis (TB) occurs up to 27 times more commonly in human immunodeficiency virus (HIV) infected patients and is also an important cause of renal amyloid; there are however no reports of renal amyloidosis in South Africa in the HIV era. Methods: This was a retrospective record review of cases of amyloidosis diagnosed on renal biopsies at our tertiary referral hospital between January 1985 and December 2016. Results: Forty-six cases of amyloidosis were identified over the study period. The calculated biopsy prevalence was 1.38 per 100 non-transplant renal biopsies (95% Confidence Interval 1.02–1.86). AL amyloidosis was identified in 26 (57%) cases and AA in 20 (43%). The median age at presentation was 51 years and 52% of cases were female. Patients with AA amyloidosis were significantly younger compared to their AL counterparts (age 42 years vs. 58 years, p = < 0.001) and were all significantly non-white. The main clinical presentation was nephrotic syndrome (85%) and 52% of cases also had a serum creatinine value of greater than 120 μmol/L. Of the 20 cases of AA amyloidosis, 12 (60%) were associated with tuberculosis. HIV infection was noted in only two (10%) of the 20 AA cases. Median survival after diagnosis was 2 months. Conclusion: Amyloidosis is a rare cause of kidney disease and typically presents with nephrotic syndrome. A similar number of AA and AL types were observed, and outcomes are worse in cases of AA amyloid. While TB remains the major underlying disease in this type, HIV infection was infrequent in cases of AA renal amyloidosis.
dc.format.extent9 pagesen_ZA
dc.publisherBMC (part of Springer Nature)en_ZA
dc.subjectChronic renal failureen_ZA
dc.titlePattern of renal amyloidosis in South Africaen_ZA
dc.description.versionPublisher's version
dc.rights.holderAuthors retain copyrighten_ZA

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