Risk Factors for Developing Renal Amyloidosis in Patients with Rheumatoid Arthritis

Nikolay F. Soroka, PhD, ScD¹,* Anastasiya K. Tushina¹, Nina G. Danilenko, PhD², Larisa N. Sivitskaya, PhD²

¹Belarusian State Medical University, Minsk, Belarus

²Institute of Genetics and Cytology, Belarusian National Academy of Sciences,Minsk, Belarus

*Corresponding author: Prof. Nikolay F. Soroka, PhD, ScD, Head of the 2nd Department of Internal Diseases, Belarusian State Medical University. 83, Dzerzhinsky avenue, 220116 Minsk, Belarus. Tel: 375-17-272-5793; Fax: 375-17-272-5793. E-mail: soroka1949@mail.ru


Background:. Secondary or acquired amyloidosis (AA) develops in patients with chronic infections and inflammatory diseases such as rheumatoid arthritis (RA). The detection of risk factors is one of the most important objectives that will help to improve the patient’s survival.

Methods and results: In this study, we observed 104 patients: 45 (1st group) with RA complicated by renal amyloidosis (histologically confirmed) and 59 RA patients without this complication (2nd group). All patients were Belarusian citizens. Patient’s previous medical history and data were analyzed. All patients had undergone tests for the detection of C. trachomatis infection. Urethra or cervical scrapes were analyzed by polymerase chain reaction (PCR) method and/or by cultural method; the presence of C. trachomatis G and M antibodies was detected by immunoenzyme assay. Further, we compared the influence of the SAA1 gene polymorphism in AA-positive RA patients with those in AA-negative RA. A statistical analysis was conducted to detect possible risk factors for developing renal amyloidosis secondary to RA. The odds ratio (OR) calculated for the SAA1 α/α genotype was 45.26 ( 95%CI: 9.9– 206.8). It was shown that the SAA1 α/α genotype dominated in both groups and consisted 95.6% (1st group) and 32.2% (2nd group), respectively. The OR for C. trachomatis infection was 26.6 (95%CI: 9.26–76.37). Further, we created a prognostic model to determine the risk factors for developing renal amyloidosis in patients with RA.

Conclusions: The risk of developing secondary amyloidosis in RA patients significantly depends on SAA1 genotype and the presence of C. trachomatis infection and can be evaluated using the prognostic model.

secondary amyloidosis, rheumatoid arthritis, risk factors
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This article is based on “Risk factors of renal amyloidosis in patients with rheumatoid arthritis”( N.F. Soroka et al. International Journal of Biomedicine 2010; 1:14-23) and updated.

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