Amyloidosis kidneys, what it is?


  • The concept of amyloidosis of the kidneys
  • Causes and mechanism for the development of amyloidosis kidneys
  • The main symptoms of amyloidosis kidneys
  • Diagnosis of the disease
  • Treatment of amyloidosis kidneys

  • The concept of amyloidosis of the kidneys

    Amilidosis - in most cases, the systemic disease is based on changes leading to extracellular falling into the amyloid tissue (represents a complex protein-polysaccharide complex), causing ultimately violation of organs of organs.

    The fibrillary protein of the amyloid in some cases has a number of properties rapping it with immunoglobulins, in others - without possessing these properties, has an antigenic agent with a serum protein, which is considered the precursor of the amyloid.

    Amyloidosis of the kidneys - manifestation of total amyloidosis. Amilide in this organ usually postponed in the main membrane.

    Causes and mechanism for the development of amyloidosis kidneys

    Causes and mechanisms for the development of amyloidosis kidneys are unknown. This condition is usually associated with the presence in the body of a chronic infection (tuberculosis, syphilis) or an ingoing reaction (osteomyelitis, pulmonary suppuration). This is the so-called secondary amyloidosis.

    Secondary amyloidosis and with diseases such as rheumatoid arthritis, ulcerative colitis, some tumors, tightening septic endocarditis. There are also primary amyloidosis, amyloidosis during myeloma and valdenstorm disease, hereditary (family), senile and local (tumor) amyloidosis.

    Although the causes and mechanisms of the development of preferential defeat of some organs (kidneys, intestines, leather, etc.) With different variants of amyloidosis, there are not quite clear, there are still data that allows you to identify links for the development of this complex disease. The conditions that contribute to the emergence and development of amyloidosis include dispensenemia, reflecting perverted protein-synthetic function, and immunological changes relating to, above all, the cell system of immunity (inhibition of the T-system, phagocytosis changes, and T. NS.).

    The main symptoms of amyloidosis kidneys

    Amyloidosis kidneys, what is it?The symptoms and the flow of amyloidosis are diverse and depend on the localization of amyloid deposits, the degree of their prevalence in organs, the duration of the course of the disease, the availability of complications. Kidney damage is typical not only with the most common secondary form of amyloidosis, but also in primary, including hereditary amyloidosis.

    The patients with amyloidosis of the kidneys do not have any complaints, and only the appearance of edema, their distribution, strengthening of general weakness, a sharp decrease in activity, the development of renal failure, arterial hypertension, the connection of complications (for example, renal veins thrombosis with pain and Anuria) forcing patients Contact doctor. Sometimes there is diarrhea.

    The most important symotosis of amyloidosis kidneys - proteinuria (protein in the urine). It develops with all its forms, but most characteristic of secondary amyloidosis. With urine per day, up to 40 g of protein is released, the main part of which is albumin. There is no protein in the urine. Prolonged loss of protein by the kidneys leads to hypoproteinemia (decrease in the concentration of protein in the blood) and the resulting enemy syndrome.

    With amyloidosis, swelling is gained and persisted in the terminal stage of Uremia. Disproteinemia is also manifested by a significant increase in ESP and a change in sedimentary samples. With pronounced amyloidosis, hyperlipidemia arises (increase in blood lipids) due to an increase in blood content of cholesterol and fatty acids. The combination of massive proteinuria, hypoproteinemia, hypercholesterolemia and edema (classic nephrotic syndrome) is characteristic of amyloidosis with predominant kidney damage.

    Diagnosis of the disease

    In the study of urine, in addition to the protein, cylinders, red blood cells, leukocytes are found in the sediment.

    Among other manifestations of amyloidosis, there are violations of the function of the cardiovascular system (primarily in the form of hypotension, rare hypertension, various conduction disturbances and heart rate, heart failure), as well as the gastrointestinal tract (suction disorders syndrome). It is often noted to increase the liver and spleen, sometimes without explicit signs of changing their function.

    The appearance and progression of proteinuria, especially the occurrence of nephrotic syndrome or renal failure, in the presence of signs of the disease, in which amyloidosis can develop, are of paramount importance to the diagnosis. But the amyloidosis should be thought of and in the absence of instructions on such a disease, especially when the cause of renal pathology remains unclear.

    The method of providing reliable diagnosis of amyloidosis is currently biopsy of the body, the most reliable kidneys, but also the mucous membrane of the rectum, less often the tissue of the gums, leather, liver. Morphological confirmation is necessary in all cases where careful study of the history, including family, clinical manifestations and laboratory indicators make the diagnosis of amyloidosis.

    Treatment of amyloidosis kidneys

    The treatment (specific) of amyloidosis is not developed, which is associated with the lack of final ideas about the causes and mechanisms for the development of this disease. For the forecast, the activity of the treatment of the disease, which led to the development of amyloidosis. Patients with amyloidosis shown long (1.5-2 years) Reception of crude liver (100-120 g / day).

    In the initial stages of the process, drugs of 4-amino-quinoline series are prescribed (made of 0.25 g 1 time per day long under the control of blood tests, as there may be a decrease in blood leukocytes). Okulist control is needed - it is possible to deposit derivatives of the drug in refractive media.

    The question of the feasibility of the use of corticosteroid and cytostatic drugs is finally not resolved. Amoloidosis should be considered rather contraindicated to the treatment with these drugs, the introduction courses of 5% of the system of unitiola 5-10 ml in / m are applied (30-40 days). The possibility of using colchicine is discussed. The volume of symptomatic therapy is determined by the severity of certain manifestations (diuretic with significant edema syndrome, hypotensive agents in the presence of arterial hypertension and T. D.). The possibility of using hemodialysis and kidney transplantation in the terminal stage of renal failure during amyloidosis is still being studied.

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