Abstract
The role of secondary amyloidosis in determining the prognosis of dialyzed patients with rheumatoid arthritis (RA) was examined in 22 patients with a mean age of 60.1 years included 21 renal amyloidosis. RA duration until the start of dialysis was 19.5 ± 7.2 years and the observation period after introduction 27.1 ± 26.4 months. Of the 14 dead cases, four died due to sepsis, three due to gastrointestinal tract bleeding, two due to congestive heart failure, and eight cases died within 5 months after starting dialysis. When comparing the eight survivors and the nine non-survivors who died within 2 years after the start of dialysis, the former patients showed significantly higher serum albumin, and lower electrocardiogram score and cardiothoracic ratios at the time of introduction to dialysis. The careful prevention and treatment of infection, cerebrovascular and/or gastrointestinal tract complications seem to be necessary to improve the prognosis of RA patients after the initiation of renal replacement therapy.
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References
Korpela M, Mustonen J, Helin H, Pastenack A (1990) Immunological comparison of patients with rheumatoid arthritis with and without nephropathy. Ann Rheum Dis 49:214–218
Nakano M, Ueno M, Nishi S, Shimada H, Hasegawa H, Watanabe T, Kurada T, Sato T, Maruyama Y, Arakawa M (1998) Analysis of renal pathology and drug history in 158 Japanese patients with rheumatoid arthritis. Clin Nephrol 50:154–160
Helin H, Korpela M, Mustonen J, Pasternack A (1986) Mild mesangial glomerulonephritis:frequent finding in rheumatoid arthritis patients with haemtauria or proteinuria. Nephron 42:224–230
Nakkai S (2003) for Statistical Survey Committee of Jpn Soc Dial Ther: an overview of dialysis treatment in Japan (as of Dec 31, 2001). J Jpn Soc Dial Ther 36:1–31
Tomita J, Kimura G, Inoue T, Inenga T, Sanai T, Kawano Y, Nakamura S, Baba S, Matsuoka H, Omae T (1995) Role of systolic blood pressure in determining prognosis of hemodialyzed patients. Am J Kidney Dis 25:405–412
Lowrie EG, Lew NL (1990) Death risk in hemodialysis patients: the predictive value of commonly measured variables and an evaluation of death rate differences between facilities. Am J Kidney Dis 15:458–482
Zimmermann J, Herrlinger S, Pruy A, Metzger T (1999) Inflammation enhances cadiovascular risk and mortality in hemodialysis patients. Kidney Int 55:648–658
Shimada Y, Tosa H, Terasawa K, Tanaka M (1992) A gastrointestinal endoscopic study on secondary amyloidosis complicating rheumatoid arthritis. Dig Endosc 4:37–42
Kobayashi H, Tada S, Fuchigami T, Okuda Y, Takasugi K, Matsumoto T, Iida M, Aoyagi K, Iwashita A, Daimaru Y, Fujishima M (1996) Secondary amyloidosis in patients with rheumatoid arthritis: diagnostic and prognostic value of gastroduodenal biopsy. Br J Rheumatol 35:44–49
Wright JR, Calkins E (1981) Clinical-pathologic differentiation of common amyloid syndromes. Medicine 60:429–428
Rostand SG, Brubzell JD, Cannon RO, Victor RG (1991) Cardiovascular complications in renal failure. J Am Soc Nephrol 2:1053–1062
Anderson CB, Codd JR, Graff RA, Graff RA, Groce MAM, Harter HR, Newton W (1978) Cardiac failure and upper extremity arteriovenous dialysis fistulas. Arch Intern Med 136:292–297
Ingram CW, Satler LF, Rackley CR (1987) Progressive heart failure secondary to a high output state. Chest 92:1117–1118
Browning MJ, Banks RA, Harrison P, Tribe CR, Fraley CT, ZacHary G, Machenzuie C (1984) Continuous ambulatory peritoneal dialysis in systemic amyloidosis and end-stage renal disease. J Royal Soc Med 77:189–192
Banks RA (1984) CAPD in end-stage renal amyloidosis. J Royal Soc Med 77:1064–1065
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We thank Mr. B. Quinn for carefully reading and editing the manuscript.
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Sanai, T., Nanishi, F., Nagata, M. et al. Role of amyloidosis in determining the prognosis of dialyzed patients with rheumatoid arthritis. Rheumatol Int 27, 363–367 (2007). https://doi.org/10.1007/s00296-006-0225-1
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DOI: https://doi.org/10.1007/s00296-006-0225-1