Presentation, survival and prognostic markers in AA amyloidosis

We reviewed 43 patients with AA amyloidosis who presented to our unit between 1985-1999: 70% had an underlying chronic rheumatological diagnosis. Median (95% CI) patient survival from time of diagnosis was 52.9 months (9.4-96.6) and median renal survival was 18 months (3.2-32.8) Twenty-four patients have died; 42% of deaths were due to infection, while renal failure accounted for 12.5%. Presenting factors which adversely influenced outcome were a low serum albumin and a high 24-h urinary albumin excretion (p=0.007 and p=0.003, respectively). Stepwise multivariate regression analysis identified albuminuria and presenting creatinine clearance as significant predictors. (p=0.005 and p=0.035, respectively). Mean C-reactive protein (CRP) throughout follow-up correlated weakly but not significantly with survival off dialysis (p=0.06). Change in creatinine clearance correlated with albuminuria. (r(2)=40%, p=0.001)