Renal amyloidosis is rare as an isolated entity but can be associated with systemic amyloidosis.
Renal involvement is estimated to affect a large proportion of the patients with systemic amyloidosis, with about half of them dying of renal failure complications 8.
It usually manifests as nephrotic syndrome:
- primary amyloidosis
- secondary amyloidosis: aging, chronic infection, chronic inflammatory diseases, tumors, rheumatoid arthritis, Hodgkin disease
Imaging findings tend to be non-specific and are not always present, but smaller and thinned cortex kidneys are seen in about 50% of patients with systemic amyloidosis 3,8. A note is made that, in acute stages, the kidneys may be enlarged. Rarely, amyloid deposition may create focal parenchymal mass lesions 3.
- increased echogenicity
- prominent medullary pyramids
- heterogeneous contrast enhancement
- amorphous renal calcifications 3
- T2: affected areas are hypointense
- irregular narrowing and tortuosity of interlobar arteries
- non-visualization of cortical arterial branches
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- 2. Moon WK, Kim SH, Im JG et-al. Castleman disease with renal amyloidosis: imaging findings and clinical significance. Abdom Imaging. 1995;20 (4): 376-8. Pubmed citation
- 3. Kawashima A, Alleman WG, Takahashi N et-al. Imaging evaluation of amyloidosis of the urinary tract and retroperitoneum. Radiographics. 2011;31 (6): 1569-82. doi:10.1148/rg.316115519 - Pubmed citation
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- 5. Dember LM. Amyloidosis-associated kidney disease. J. Am. Soc. Nephrol. 2006;17 (12): 3458-71. J. Am. Soc. Nephrol. (full text) - doi:10.1681/ASN.2006050460 - Pubmed citation
- 6. Moon WK, Kim SH, Im JG et-al. Castleman disease with renal amyloidosis: imaging findings and clinical significance. Abdom Imaging. 1995;20 (4): 376-8. Pubmed citation
- 7. Apter S, Zemer D, Terhakopian A et-al. Abdominal CT findings in nephropathic amyloidosis of familial Mediterranean fever. Amyloid. 2001;8 (1): 58-64. Pubmed citation
- 8. Özcan HN, Haliloğlu M, Sökmensüer C, Akata D, Özmen M, Karçaaltıncaba M. Imaging for abdominal involvement in amyloidosis. (2017) Diagnostic and interventional radiology (Ankara, Turkey). 23 (4): 282-285. doi:10.5152/dir.2017.16484 - Pubmed