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Renal AA Amyloidosis in Patients with Type 2 Diabetes Mellitus

Ramón Díez1, Magdalena Madero1, Gerardo Gamba2

  • 1Department of Nephrology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.

Nephron Extra
|October 23, 2014
PubMed
Abstract

Insights

Renal AA amyloidosis (RAAA) is common in type 2 diabetes mellitus (T2DM) and linked to worse cardiovascular disease (CVD) and kidney issues. This suggests RAAA indicates severe chronic inflammation in T2DM patients.

Area of Science:

  • Nephrology
  • Cardiology
  • Pathology

Background:

  • Type 2 diabetes mellitus (T2DM) is a primary driver of chronic kidney disease and cardiovascular disease (CVD) mortality.
  • Chronic inflammation is integral to T2DM pathogenesis, often leading to reactive amyloidosis.
  • Reactive amyloidosis, specifically renal AA amyloidosis (RAAA), may exacerbate atherosclerosis and CVD in T2DM patients.

Purpose of the Study:

  • To investigate the prevalence of renal AA amyloidosis (RAAA) in patients with type 2 diabetes mellitus (T2DM).
  • To determine the association between RAAA and the severity of atherosclerosis and cardiovascular disease (CVD) in T2DM patients.

Main Methods:

  • Analysis of 330 autopsy kidneys from diagnosed T2DM patients.
  • Histopathological evaluation for diabetic nephropathy and RAAA.
  • Assessment of systemic vessels for atherosclerosis.

Main Results:

  • RAAA was identified in 9% of the T2DM cohort.
  • RAAA correlated with increased risks of nodular sclerosis, chronic ischemic cardiomyopathy, and myocardial infarction.
  • RAAA was associated with significantly higher rates of aortic, coronary, and intrarenal atherosclerosis.

Conclusions:

  • Renal AA amyloidosis (RAAA) is a prevalent finding in type 2 diabetes mellitus (T2DM).
  • RAAA is significantly associated with adverse cardiovascular and renal outcomes in T2DM.
  • RAAA may serve as a biomarker for severe chronic inflammation contributing to T2DM complications.
Keywords:
Advanced glycation end productsAtherosclerosisDiabetic nephropathySerum amyloid A

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