Renal amyloidosis is rare as an isolated entity but can be associated with systemic amyloidosis.
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Epidemiology
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.
Clinical presentation
It usually manifests as nephrotic syndrome:
abdominal pain
oedema
urinary symptoms when urinary tract is involved
Pathology
Aetiology
primary amyloidosis
secondary amyloidosis: ageing, chronic infection, chronic inflammatory diseases, tumours, rheumatoid arthritis, Hodgkin disease
Associations
Complications
Radiographic features
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.
Ultrasound
increased echogenicity
prominent medullary pyramids
bilateral renal enlargements
CT
heterogeneous contrast enhancement
amorphous renal calcifications 3
MRI
T2: affected areas are hypointense
Angiography (DSA)
irregular narrowing and tortuosity of interlobar arteries
non-visualisation of cortical arterial branches
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