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J Nephropathol. 2025;14(2): e21507.
doi: 10.34172/jnp.2025.21507
  Abstract View: 2
  PDF Download: 3

Original Article

Clinicopathological study of renal amyloidosis and its relationship with renal amyloid prognostic score

Deepti Dixit 1 ORCID logo, Ranjana Shashidhar Ranade 2 ORCID logo, Hephzibah Rani 1 ORCID logo, Vidisha Sharatchandra Athanikar 1 ORCID logo, Manjunath Revanasiddappa 3* ORCID logo

1 Department of Pathology, SDM College of Medical Sciences and Hospital, Shri Dharmasthala Manjunatheshwara University, Dharwad, India
2 Department of Pathology, KLE JGMM Medical College, Hubballi, a Unit of KLE Academy of Higher Education and Research, Belagavi, India
3 Department of Nephrology, SDM College of Medical Sciences and Hospital, Shri Dharmasthala Manjunatheshwara University, Dharwad, India
*Corresponding Author: Manjunath Revanasiddappa, Email: nephrology@sdmmedicalcollege.org, Email: doc.r.manjunath@gmail.com

Abstract

Introduction: The kidney is one of the most common organs involved in systemic amyloidosis. Several studies have attempted scoring kidney amyloid deposits and predicting the outcome. A new scoring and grading scheme is proposed, known as renal amyloid prognostic score (RAPS), which provides a better means for scoring renal amyloidosis and predicting renal outcome.

Objectives: The present study aims to estimate the clinicopathological and biochemical parameters in renal amyloidosis cases and the role of RAPS in assessing renal outcome and prognosis.

Materials and Methods: This retrospective study included all diagnosed cases of renal amyloidosis from October 2017 to December 2021. Detailed clinical features and laboratory parameters were obtained from medical records, and all renal biopsies were studied using light microscopy (LM) and immunofluorescence. Congo red-stained sections were examined under a polarizer to look for amyloid deposits. RAPS was calculated on a scale of 0 to 31 and was graded from 0 to III. Pearson’s correlation coefficient was calculated between RAPS and serum creatinine, as well as between RAPS and estimated glomerular filtration rate (eGFR).

Results: Fourteen cases of renal amyloidosis were included, comprising seven cases of primary amyloidosis, of which six showed lambda light chain restriction. RAPS varied from 12 to 27. There was a strong correlation between RAPS and serum creatinine (r= 0.7) and a moderate negative correlation between RAPS and eGFR (r=-0.5).

Conclusion: Application of RAPS and, thus, uniform reporting of renal amyloidosis helps assess the disease’s severity.



Implication for health policy/practice/research/medical education:

In a retrospective study, we analysed the clinicopathological and biochemical parameters in fourteen patients of renal amyloidosis and assessed whether prognosis can be guided by renal amyloid prognostic score (RAPS). Our results suggest that renal amyloidosis had varied presentation. It adds to the literature that the application of RAPS is a valuable tool and provides an opportunity to have a uniform reporting, therefore the severity and prognosis can be assessed in renal amyloidosis.

Please cite this paper as: Dixit D, Ranade RS, Rani H, Athanikar VS, Revanasiddappa M. Clinicopathological study of renal amyloidosis and its relationship with renal amyloid prognostic score. J Nephropathol. 2025;14(2):e21507. DOI: 10.34172/jnp.2025.21507.

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Submitted: 09 Jul 2023
Revision: 17 Oct 2024
Accepted: 05 Feb 2025
ePublished: 22 Feb 2025
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