Chronic dialysis in patients with systemic amyloidosis: The experience in Northern Italy

G. Moroni, G. Banfi, A. Montoli, A. Bucci, T. Bertani, M. Ravelli, C. Pozzi, M. Leonelli, A. Lupo, A. Volpi, S. Pasquali, A. Salvadeo

Research output: Contribution to journalArticle

Abstract

The clinical outcome of 61 patients with renal amyloidosis treated with chronic dialysis was reviewed. Eighteen patients, 4 with primary or AL amyloidosis and 14 with reactive or AA amyloidosis, died within one month from starting treatment. The other 43 patients were treated with dialysis for 3 to 199 months and are the object of this study. Sixteen patients had AL amyloidosis and 27 had AA amyloidosis. Thirty-five patients were treated with hemodialysis (HD) for a mean period of 40±47 months and 8 were treated with continuous ambulatory peritoneal dialysis (CAPD) for 20±15 months. Patient survival rate at 1 and 5 years was 68% and 30% respectively. There was no difference in survival rate between patients treated with HD and those treated with CAPD, while patients younger than 45 had a better 5-year survival rate. Twenty four (60%) patients achieved a satisfactory rehabilitation with dialysis. At the last follow-up, 15 patients (14 on HD, 1 on CAPD) were alive 61±58 months after starting dialysis. Twenty-eight patients died after 30±20 months. The main causes of death were: cardiovascular accident (11), stroke (3), sepsis (5) and cachexia (5). The most important extra-renal complications of amyloidosis were related to cardiovascular involvement (heart failures, arrhythmias, hypotension) and gastrointestinal involvement (malabsorbtion). Intradialytic hypotension in patients on HD and peritonitis in patients on CAPD were the main problems related to dialytic procedure. This study confirms that life expectancy and the quality of life of dialysis patients with systemic amyloidosis are poorer than those of general dialysis population. However, some patients can show a prolonged survival and an acceptable degree of rehabilitation. Multisystemic involvement of amyloidosis before dialysis is probably the most important risk factor for these patients.

Original languageEnglish
Pages (from-to)81-85
Number of pages5
JournalClinical Nephrology
Volume38
Issue number2
Publication statusPublished - 1992

Fingerprint

Amyloidosis
Italy
Dialysis
Continuous Ambulatory Peritoneal Dialysis
Renal Dialysis
Survival Rate
Hypotension
Rehabilitation
Quality of Life
Kidney
Cachexia
Life Expectancy
Peritonitis
Accidents
Cardiac Arrhythmias
Cause of Death

Keywords

  • Dialysis
  • Systemic amyloidosis
  • Uremia

ASJC Scopus subject areas

  • Nephrology

Cite this

Moroni, G., Banfi, G., Montoli, A., Bucci, A., Bertani, T., Ravelli, M., ... Salvadeo, A. (1992). Chronic dialysis in patients with systemic amyloidosis: The experience in Northern Italy. Clinical Nephrology, 38(2), 81-85.

Chronic dialysis in patients with systemic amyloidosis : The experience in Northern Italy. / Moroni, G.; Banfi, G.; Montoli, A.; Bucci, A.; Bertani, T.; Ravelli, M.; Pozzi, C.; Leonelli, M.; Lupo, A.; Volpi, A.; Pasquali, S.; Salvadeo, A.

In: Clinical Nephrology, Vol. 38, No. 2, 1992, p. 81-85.

Research output: Contribution to journalArticle

Moroni, G, Banfi, G, Montoli, A, Bucci, A, Bertani, T, Ravelli, M, Pozzi, C, Leonelli, M, Lupo, A, Volpi, A, Pasquali, S & Salvadeo, A 1992, 'Chronic dialysis in patients with systemic amyloidosis: The experience in Northern Italy', Clinical Nephrology, vol. 38, no. 2, pp. 81-85.
Moroni G, Banfi G, Montoli A, Bucci A, Bertani T, Ravelli M et al. Chronic dialysis in patients with systemic amyloidosis: The experience in Northern Italy. Clinical Nephrology. 1992;38(2):81-85.
Moroni, G. ; Banfi, G. ; Montoli, A. ; Bucci, A. ; Bertani, T. ; Ravelli, M. ; Pozzi, C. ; Leonelli, M. ; Lupo, A. ; Volpi, A. ; Pasquali, S. ; Salvadeo, A. / Chronic dialysis in patients with systemic amyloidosis : The experience in Northern Italy. In: Clinical Nephrology. 1992 ; Vol. 38, No. 2. pp. 81-85.
@article{ef5d924f96344dc396b2cafa35923458,
title = "Chronic dialysis in patients with systemic amyloidosis: The experience in Northern Italy",
abstract = "The clinical outcome of 61 patients with renal amyloidosis treated with chronic dialysis was reviewed. Eighteen patients, 4 with primary or AL amyloidosis and 14 with reactive or AA amyloidosis, died within one month from starting treatment. The other 43 patients were treated with dialysis for 3 to 199 months and are the object of this study. Sixteen patients had AL amyloidosis and 27 had AA amyloidosis. Thirty-five patients were treated with hemodialysis (HD) for a mean period of 40±47 months and 8 were treated with continuous ambulatory peritoneal dialysis (CAPD) for 20±15 months. Patient survival rate at 1 and 5 years was 68{\%} and 30{\%} respectively. There was no difference in survival rate between patients treated with HD and those treated with CAPD, while patients younger than 45 had a better 5-year survival rate. Twenty four (60{\%}) patients achieved a satisfactory rehabilitation with dialysis. At the last follow-up, 15 patients (14 on HD, 1 on CAPD) were alive 61±58 months after starting dialysis. Twenty-eight patients died after 30±20 months. The main causes of death were: cardiovascular accident (11), stroke (3), sepsis (5) and cachexia (5). The most important extra-renal complications of amyloidosis were related to cardiovascular involvement (heart failures, arrhythmias, hypotension) and gastrointestinal involvement (malabsorbtion). Intradialytic hypotension in patients on HD and peritonitis in patients on CAPD were the main problems related to dialytic procedure. This study confirms that life expectancy and the quality of life of dialysis patients with systemic amyloidosis are poorer than those of general dialysis population. However, some patients can show a prolonged survival and an acceptable degree of rehabilitation. Multisystemic involvement of amyloidosis before dialysis is probably the most important risk factor for these patients.",
keywords = "Dialysis, Systemic amyloidosis, Uremia",
author = "G. Moroni and G. Banfi and A. Montoli and A. Bucci and T. Bertani and M. Ravelli and C. Pozzi and M. Leonelli and A. Lupo and A. Volpi and S. Pasquali and A. Salvadeo",
year = "1992",
language = "English",
volume = "38",
pages = "81--85",
journal = "Clinical Nephrology",
issn = "0301-0430",
publisher = "Dustri-Verlag Dr. Karl Feistle",
number = "2",

}

TY - JOUR

T1 - Chronic dialysis in patients with systemic amyloidosis

T2 - The experience in Northern Italy

AU - Moroni, G.

AU - Banfi, G.

AU - Montoli, A.

AU - Bucci, A.

AU - Bertani, T.

AU - Ravelli, M.

AU - Pozzi, C.

AU - Leonelli, M.

AU - Lupo, A.

AU - Volpi, A.

AU - Pasquali, S.

AU - Salvadeo, A.

PY - 1992

Y1 - 1992

N2 - The clinical outcome of 61 patients with renal amyloidosis treated with chronic dialysis was reviewed. Eighteen patients, 4 with primary or AL amyloidosis and 14 with reactive or AA amyloidosis, died within one month from starting treatment. The other 43 patients were treated with dialysis for 3 to 199 months and are the object of this study. Sixteen patients had AL amyloidosis and 27 had AA amyloidosis. Thirty-five patients were treated with hemodialysis (HD) for a mean period of 40±47 months and 8 were treated with continuous ambulatory peritoneal dialysis (CAPD) for 20±15 months. Patient survival rate at 1 and 5 years was 68% and 30% respectively. There was no difference in survival rate between patients treated with HD and those treated with CAPD, while patients younger than 45 had a better 5-year survival rate. Twenty four (60%) patients achieved a satisfactory rehabilitation with dialysis. At the last follow-up, 15 patients (14 on HD, 1 on CAPD) were alive 61±58 months after starting dialysis. Twenty-eight patients died after 30±20 months. The main causes of death were: cardiovascular accident (11), stroke (3), sepsis (5) and cachexia (5). The most important extra-renal complications of amyloidosis were related to cardiovascular involvement (heart failures, arrhythmias, hypotension) and gastrointestinal involvement (malabsorbtion). Intradialytic hypotension in patients on HD and peritonitis in patients on CAPD were the main problems related to dialytic procedure. This study confirms that life expectancy and the quality of life of dialysis patients with systemic amyloidosis are poorer than those of general dialysis population. However, some patients can show a prolonged survival and an acceptable degree of rehabilitation. Multisystemic involvement of amyloidosis before dialysis is probably the most important risk factor for these patients.

AB - The clinical outcome of 61 patients with renal amyloidosis treated with chronic dialysis was reviewed. Eighteen patients, 4 with primary or AL amyloidosis and 14 with reactive or AA amyloidosis, died within one month from starting treatment. The other 43 patients were treated with dialysis for 3 to 199 months and are the object of this study. Sixteen patients had AL amyloidosis and 27 had AA amyloidosis. Thirty-five patients were treated with hemodialysis (HD) for a mean period of 40±47 months and 8 were treated with continuous ambulatory peritoneal dialysis (CAPD) for 20±15 months. Patient survival rate at 1 and 5 years was 68% and 30% respectively. There was no difference in survival rate between patients treated with HD and those treated with CAPD, while patients younger than 45 had a better 5-year survival rate. Twenty four (60%) patients achieved a satisfactory rehabilitation with dialysis. At the last follow-up, 15 patients (14 on HD, 1 on CAPD) were alive 61±58 months after starting dialysis. Twenty-eight patients died after 30±20 months. The main causes of death were: cardiovascular accident (11), stroke (3), sepsis (5) and cachexia (5). The most important extra-renal complications of amyloidosis were related to cardiovascular involvement (heart failures, arrhythmias, hypotension) and gastrointestinal involvement (malabsorbtion). Intradialytic hypotension in patients on HD and peritonitis in patients on CAPD were the main problems related to dialytic procedure. This study confirms that life expectancy and the quality of life of dialysis patients with systemic amyloidosis are poorer than those of general dialysis population. However, some patients can show a prolonged survival and an acceptable degree of rehabilitation. Multisystemic involvement of amyloidosis before dialysis is probably the most important risk factor for these patients.

KW - Dialysis

KW - Systemic amyloidosis

KW - Uremia

UR - http://www.scopus.com/inward/record.url?scp=0026730964&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0026730964&partnerID=8YFLogxK

M3 - Article

C2 - 1516284

AN - SCOPUS:0026730964

VL - 38

SP - 81

EP - 85

JO - Clinical Nephrology

JF - Clinical Nephrology

SN - 0301-0430

IS - 2

ER -