Serum Amyloid A Protein–Associated Kidney Disease: Presentation, Diagnosis, and Management

Jordan Thorne; David Clark; Laurette Geldenhuys; Keigan More; Amanda Vinson; Karthik Tennankore

doi:10.1016/j.xkme.2022.100504

Serum Amyloid A Protein–Associated Kidney Disease: Presentation, Diagnosis, and Management

Jordan Thorne, David Clark, Laurette Geldenhuys, Keigan More, Amanda Vinson, Karthik Tennankore

Medicine

Research output: Contribution to journal › Review article › peer-review

11 Citations (Scopus)

Abstract

Serum amyloid A protein (AA) amyloidosis, also known as secondary amyloidosis, is a known consequence of chronic inflammation and results from several conditions including inflammatory arthritis, periodic fever syndromes, and chronic infection. AA amyloidosis can lead to multiorgan dysfunction, including changes in glomerular filtration rate and proteinuria. Definitive diagnosis requires tissue biopsy, and management of AA amyloid kidney disease is primarily focused on treating the underlying inflammatory condition to stabilize glomerular filtration rate, reduce proteinuria, and slow potential progression to kidney failure. In this narrative review, we describe the causes, pathophysiology, presentation, and pathologic diagnosis of AA amyloid kidney disease using an illustrative case of biopsy-proven AA amyloid kidney disease in a patient with long-standing rheumatoid arthritis who had a favorable response to interleukin 6 inhibition. We conclude the review with a description of established and more novel therapies for AA amyloidosis including published cases of use of tocilizumab (an interleukin 6 inhibitor) in biopsy-proven AA amyloid kidney disease.

Original language	English
Article number	100504
Journal	Kidney Medicine
Volume	4
Issue number	8
DOIs	https://doi.org/10.1016/j.xkme.2022.100504
Publication status	Published - Aug 2022

Bibliographical note

Funding Information:
Jordan Thorne, MD, David Clark, MD, Laurette Geldenhuys, MD, Keigan More, MD, Amanda Vinson, MD, and Karthik Tennankore, MD, Dr Vinson has received consultancy and ad board fees from Paladin Labs Inc as well as fellowship grant funding. Dr Clark has received advisory board or consultancy fees from Baxter; received unrestricted grant funding from Baxter (for fellowship program) and Otsuka (for investigator-initiated research). Dr Tennankore has received advisory board or consultancy fees from Baxter, Bayer, AstraZeneca, Otsuka and GSK. He has received unrestricted grant funding from Baxter (for fellowship program) and Otsuka (for investigator-initiated research). The remaining authors declare that they have no relevant financial interests. Received January 25, 2022 as a submission to the expedited consideration track with 3 external peer reviews. Direct editorial input from the Editor-in-Chief. Accepted in revised form April 29, 2022.

Funding Information:
Dr Vinson has received consultancy and ad board fees from Paladin Labs Inc as well as fellowship grant funding. Dr Clark has received advisory board or consultancy fees from Baxter; received unrestricted grant funding from Baxter (for fellowship program) and Otsuka (for investigator-initiated research). Dr Tennankore has received advisory board or consultancy fees from Baxter, Bayer, AstraZeneca, Otsuka and GSK. He has received unrestricted grant funding from Baxter (for fellowship program) and Otsuka (for investigator-initiated research). The remaining authors declare that they have no relevant financial interests.

Publisher Copyright:
© 2022 The Authors

ASJC Scopus Subject Areas

Internal Medicine
Nephrology

PubMed: MeSH publication types

Journal Article
Review

Access to Document

10.1016/j.xkme.2022.100504

Cite this

@article{a69a14cf01c14a7c879a5b06cb8e153d,

title = "Serum Amyloid A Protein–Associated Kidney Disease: Presentation, Diagnosis, and Management",

abstract = "Serum amyloid A protein (AA) amyloidosis, also known as secondary amyloidosis, is a known consequence of chronic inflammation and results from several conditions including inflammatory arthritis, periodic fever syndromes, and chronic infection. AA amyloidosis can lead to multiorgan dysfunction, including changes in glomerular filtration rate and proteinuria. Definitive diagnosis requires tissue biopsy, and management of AA amyloid kidney disease is primarily focused on treating the underlying inflammatory condition to stabilize glomerular filtration rate, reduce proteinuria, and slow potential progression to kidney failure. In this narrative review, we describe the causes, pathophysiology, presentation, and pathologic diagnosis of AA amyloid kidney disease using an illustrative case of biopsy-proven AA amyloid kidney disease in a patient with long-standing rheumatoid arthritis who had a favorable response to interleukin 6 inhibition. We conclude the review with a description of established and more novel therapies for AA amyloidosis including published cases of use of tocilizumab (an interleukin 6 inhibitor) in biopsy-proven AA amyloid kidney disease.",

author = "Jordan Thorne and David Clark and Laurette Geldenhuys and Keigan More and Amanda Vinson and Karthik Tennankore",

note = "Funding Information: Jordan Thorne, MD, David Clark, MD, Laurette Geldenhuys, MD, Keigan More, MD, Amanda Vinson, MD, and Karthik Tennankore, MD, Dr Vinson has received consultancy and ad board fees from Paladin Labs Inc as well as fellowship grant funding. Dr Clark has received advisory board or consultancy fees from Baxter; received unrestricted grant funding from Baxter (for fellowship program) and Otsuka (for investigator-initiated research). Dr Tennankore has received advisory board or consultancy fees from Baxter, Bayer, AstraZeneca, Otsuka and GSK. He has received unrestricted grant funding from Baxter (for fellowship program) and Otsuka (for investigator-initiated research). The remaining authors declare that they have no relevant financial interests. Received January 25, 2022 as a submission to the expedited consideration track with 3 external peer reviews. Direct editorial input from the Editor-in-Chief. Accepted in revised form April 29, 2022. Funding Information: Dr Vinson has received consultancy and ad board fees from Paladin Labs Inc as well as fellowship grant funding. Dr Clark has received advisory board or consultancy fees from Baxter; received unrestricted grant funding from Baxter (for fellowship program) and Otsuka (for investigator-initiated research). Dr Tennankore has received advisory board or consultancy fees from Baxter, Bayer, AstraZeneca, Otsuka and GSK. He has received unrestricted grant funding from Baxter (for fellowship program) and Otsuka (for investigator-initiated research). The remaining authors declare that they have no relevant financial interests. Publisher Copyright: {\textcopyright} 2022 The Authors",

year = "2022",

month = aug,

doi = "10.1016/j.xkme.2022.100504",

language = "English",

volume = "4",

journal = "Kidney Medicine",

issn = "2590-0595",

publisher = "Elsevier Inc.",

number = "8",

}

TY - JOUR

T1 - Serum Amyloid A Protein–Associated Kidney Disease

T2 - Presentation, Diagnosis, and Management

AU - Thorne, Jordan

AU - Clark, David

AU - Geldenhuys, Laurette

AU - More, Keigan

AU - Vinson, Amanda

AU - Tennankore, Karthik

N1 - Funding Information: Jordan Thorne, MD, David Clark, MD, Laurette Geldenhuys, MD, Keigan More, MD, Amanda Vinson, MD, and Karthik Tennankore, MD, Dr Vinson has received consultancy and ad board fees from Paladin Labs Inc as well as fellowship grant funding. Dr Clark has received advisory board or consultancy fees from Baxter; received unrestricted grant funding from Baxter (for fellowship program) and Otsuka (for investigator-initiated research). Dr Tennankore has received advisory board or consultancy fees from Baxter, Bayer, AstraZeneca, Otsuka and GSK. He has received unrestricted grant funding from Baxter (for fellowship program) and Otsuka (for investigator-initiated research). The remaining authors declare that they have no relevant financial interests. Received January 25, 2022 as a submission to the expedited consideration track with 3 external peer reviews. Direct editorial input from the Editor-in-Chief. Accepted in revised form April 29, 2022. Funding Information: Dr Vinson has received consultancy and ad board fees from Paladin Labs Inc as well as fellowship grant funding. Dr Clark has received advisory board or consultancy fees from Baxter; received unrestricted grant funding from Baxter (for fellowship program) and Otsuka (for investigator-initiated research). Dr Tennankore has received advisory board or consultancy fees from Baxter, Bayer, AstraZeneca, Otsuka and GSK. He has received unrestricted grant funding from Baxter (for fellowship program) and Otsuka (for investigator-initiated research). The remaining authors declare that they have no relevant financial interests. Publisher Copyright: © 2022 The Authors

PY - 2022/8

Y1 - 2022/8

N2 - Serum amyloid A protein (AA) amyloidosis, also known as secondary amyloidosis, is a known consequence of chronic inflammation and results from several conditions including inflammatory arthritis, periodic fever syndromes, and chronic infection. AA amyloidosis can lead to multiorgan dysfunction, including changes in glomerular filtration rate and proteinuria. Definitive diagnosis requires tissue biopsy, and management of AA amyloid kidney disease is primarily focused on treating the underlying inflammatory condition to stabilize glomerular filtration rate, reduce proteinuria, and slow potential progression to kidney failure. In this narrative review, we describe the causes, pathophysiology, presentation, and pathologic diagnosis of AA amyloid kidney disease using an illustrative case of biopsy-proven AA amyloid kidney disease in a patient with long-standing rheumatoid arthritis who had a favorable response to interleukin 6 inhibition. We conclude the review with a description of established and more novel therapies for AA amyloidosis including published cases of use of tocilizumab (an interleukin 6 inhibitor) in biopsy-proven AA amyloid kidney disease.

AB - Serum amyloid A protein (AA) amyloidosis, also known as secondary amyloidosis, is a known consequence of chronic inflammation and results from several conditions including inflammatory arthritis, periodic fever syndromes, and chronic infection. AA amyloidosis can lead to multiorgan dysfunction, including changes in glomerular filtration rate and proteinuria. Definitive diagnosis requires tissue biopsy, and management of AA amyloid kidney disease is primarily focused on treating the underlying inflammatory condition to stabilize glomerular filtration rate, reduce proteinuria, and slow potential progression to kidney failure. In this narrative review, we describe the causes, pathophysiology, presentation, and pathologic diagnosis of AA amyloid kidney disease using an illustrative case of biopsy-proven AA amyloid kidney disease in a patient with long-standing rheumatoid arthritis who had a favorable response to interleukin 6 inhibition. We conclude the review with a description of established and more novel therapies for AA amyloidosis including published cases of use of tocilizumab (an interleukin 6 inhibitor) in biopsy-proven AA amyloid kidney disease.

UR - http://www.scopus.com/inward/record.url?scp=85134707192&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85134707192&partnerID=8YFLogxK

U2 - 10.1016/j.xkme.2022.100504

DO - 10.1016/j.xkme.2022.100504

M3 - Review article

C2 - 35879979

AN - SCOPUS:85134707192

SN - 2590-0595

VL - 4

JO - Kidney Medicine

JF - Kidney Medicine

IS - 8

M1 - 100504

ER -

Serum Amyloid A Protein–Associated Kidney Disease: Presentation, Diagnosis, and Management

Abstract

Bibliographical note

ASJC Scopus Subject Areas

PubMed: MeSH publication types

Access to Document

Other files and links

Fingerprint

Cite this