[Morphogenesis and course of renal amyloidosis]

Based on an analysis of the clinicolaboratory findings and morphological examination of 93 patients with renal amyloidosis the proteinuric stage was diagnosed in 24, the nephrotic in 35, and the azotemic in 34 patients. Elevation of the arterial blood pressure was revealed in 40% of the patients. During the first year since proteinuria was diagnosed, the nephrotic syndrome developed in 50% of the patients; renal failure in 75% of cases developed over 9 years. The 5-year survival since proteinuria was diagnosed amounted to 72%, the 10-year survival to 34%. The 5-year survival among patients with the nephrotic syndrome constituted 49%, whereas the 10-year survival was attained only in single cases. One year after blood creatinine became elevated only 30% of the patients were still alive. As the disease progressed, there was a gradual increase in amyloid impregnation of the glomeruli alone, while amyloidosis of the tubules was most pronounced in the nephrotic stage. No complete correlation was found between the gravity of the morphological picture of glomerular involvement and blood creatinine level which is undoubtedly influenced by alterations in the exoglomerular structures.