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Related Experiment Videos

Adrenal dysfunction in patients with renal amyloid.

P Danby1, K P Harris, B Williams

  • 1Department of Nephrology, Leicester General Hospital, U.K.

The Quarterly Journal of Medicine
|September 1, 1990
PubMed
Summary

Renal amyloidosis patients often have adrenal dysfunction. Adrenal insufficiency was noted in 7 of 16 patients, contributing to deaths. Early adrenal function assessment and steroid therapy are recommended for renal amyloidosis.

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Area of Science:

  • Nephrology
  • Endocrinology
  • Pathology

Background:

  • Amyloidosis is a systemic disease with frequent renal involvement, often leading to end-stage renal failure.
  • Renal amyloidosis prognosis is poor, necessitating comprehensive patient management.
  • Adrenal gland involvement in renal amyloidosis is not fully understood.

Purpose of the Study:

  • To investigate the adrenal status of patients with renal amyloidosis undergoing or considered for renal replacement therapy.
  • To determine the prevalence of adrenal dysfunction in this patient cohort.
  • To assess the impact of adrenal insufficiency on patient outcomes.

Main Methods:

  • The study included 22 patients with renal amyloidosis (12 AA amyloid, 10 AL amyloid) evaluated for renal replacement therapy.

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  • Adrenal function was assessed using the synacthen test in 16 patients.
  • Autopsy findings were reviewed for evidence of amyloid deposition in adrenal glands.

    • Main Results:

    • Seven out of 16 tested patients showed an abnormal response to the synacthen test, indicating adrenal insufficiency.
    • Four patients died from Addisonian crisis.
    • Adrenal insufficiency likely contributed to the deaths of two additional patients.
    • Amyloid deposition was found in the adrenal glands of seven deceased patients.

    Conclusions:

    • Adrenal dysfunction is a significant complication in patients with renal amyloidosis.
    • Routine assessment of adrenal function is crucial for patients with renal amyloidosis.
    • Prompt initiation of steroid replacement therapy for adrenal insufficiency may improve outcomes.