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A clinical evaluation of renal amyloidosis in the Japan renal biopsy registry: a cross-sectional study

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Abstract

Background and aim

The available clinical data are limited in a rare glomerular disease, renal amyloidosis. We aimed to clarify the clinical features of renal amyloidosis from database of the Japan Renal Biopsy Registry (J-RBR).

Methods

We performed a cross-sectional study with database of the J-RBR of the Japanese Society of Nephrology. We identified 281 cases of renal amyloidosis from 20,997 cases enrolled into the J-RBR from 2007 to 2014. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were compared among the levels of ages, amount of urine protein excretion (AUPE) or CKD G stages.

Results

The prevalence of renal amyloidosis was 1.3 % (281/20,997). DBP significantly decreased in higher age quartiles (P = 0.034). SBP and DBP did not increase in the progression of AUPE levels and CKD G stages. In multiple regression analysis, eGFR was a significant independent factor for SBP in all cases and a subgroup without hypertensive agents. There was a reverse significant relationship between SBP and eGFR.

Conclusion

Blood pressure did not significantly increase in elderly and much proteinuric condition in renal amyloidosis. The progression of CKD and decrease of eGFR did not produce the higher SBP. The mechanism underlying these results remains unclear; however, they are unique features of renal amyloidosis. The couple of hypotensive and hypertensive conditions might produce no relationship between blood pressure and CKD stages.

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Acknowledgments

The authors are grateful for the help and support from the J-RBR committee and all of the colleagues who participated in the J-RBR governed by Japanese Society of Nephrology. This study was supported by a grant-in-aid from the Research Group on Progressive Renal Disease, Grant-in-Aid for Research on Advanced Chronic Kidney Disease, from the Japan Agency for Medical Research and Development, and the Amyloidosis Research Group from the Ministry of Health Labor and Welfare (Number H26-057), Japan.

Author information

Authors and Affiliations

  1. Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki, Chuo-ku, Kobe, Hyogo, 650-0017, Japan

    Shinichi Nishi, Shunsuke Goto & Hideki Fujii

  2. Center of Nephrology and Urology, Division of Nephrology and Dialysis, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, 2-4-20 Ohgimachi, Kita-ku, Osaka, 530-8480, Japan

    Eri Muso

  3. Department of Analytic Human Pathology, Nippon Medical School, 1-1-5, Sendagi, Tokyo, 113-8602, Japan

    Akira Shimizu

  4. Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, 2-5-1 Shikata, Okayama, 700-8558, Japan

    Hitoshi Sugiyama

  5. Department of Nephrology, Kanazawa Medical University School of Medicine, 1-1 Daigaku, Uchinada, Ishikawa, 920-0293, Japan

    Hitoshi Yokoyama

  6. Department of Neurology, Department of Diagnostic Medicine, Graduate School of Medical Science, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan

    Yukio Ando

Authors
  1. Shinichi Nishi
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  2. Eri Muso
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  3. Akira Shimizu
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  4. Hitoshi Sugiyama
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  5. Hitoshi Yokoyama
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  6. Yukio Ando
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  7. Shunsuke Goto
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  8. Hideki Fujii
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Corresponding author

Correspondence to Shinichi Nishi.

Ethics declarations

The ethical committee of the Japanese Society of Nephrology comprehensively examined and approved the study protocol. The J-RBR is registered at the Clinical Trial Registry of UMIN (UMIN000000618). Informed consent was obtain from all participants.

Conflict of interest

The authors declare no conflict of interest regarding this paper.

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Nishi, S., Muso, E., Shimizu, A. et al. A clinical evaluation of renal amyloidosis in the Japan renal biopsy registry: a cross-sectional study. Clin Exp Nephrol 21, 624–632 (2017). https://doi.org/10.1007/s10157-016-1326-0

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  • DOI: https://doi.org/10.1007/s10157-016-1326-0

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