BACKGROUND: Intravenous drug abuse is associated with a wide variety of acute and chronic medical complications. The increased longevity of drug users has seen the emergence of new diseases as a result of chronic bacterial and viral infection. We recently observed an increase in the number of cases of renal amyloidosis among intravenous drug users in central London. AIM: To describe here the demographic and clinical characteristics of such patients. METHODS: Patients were identified retrospectively from computerized patient renal biopsy records at University College London and Royal Free Hospitals from 1990-2005. Clinical information was collected from patient hospital records. RESULTS: We identified 20 cases of AA amyloidosis; 65% occurred between January 2000 and September 2005. All were proteinuric (mean 7.3 g/l, range 0.5-14.8 g/l) and 13 required dialysis within 1 month of diagnosis. Of the remaining seven, four developed end-stage renal failure after mean follow-up of 16 months (range 6-30). Nine died, with median survival of 19 months (range 1-62); all deaths were due to sepsis. DISCUSSION: Secondary AA amyloidosis is a serious complication of chronic soft tissue infection in intravenous drug users in central London. Affected individuals invariably presented with nephrotic range proteinuria and advanced renal failure. Treatment options are limited and the outcome for such patients on renal replacement was poor. Cross-disciplinary strategies are needed to prevent this serious complication of long-term intravenous drug abuse.
BACKGROUND: Intravenous drug abuse is associated with a wide variety of acute and chronic medical complications. The increased longevity of drug users has seen the emergence of new diseases as a result of chronic bacterial and viral infection. We recently observed an increase in the number of cases of renal amyloidosis among intravenous drug users in central London. AIM: To describe here the demographic and clinical characteristics of such patients. METHODS: Patients were identified retrospectively from computerized patient renal biopsy records at University College London and Royal Free Hospitals from 1990-2005. Clinical information was collected from patient hospital records. RESULTS: We identified 20 cases of AA amyloidosis; 65% occurred between January 2000 and September 2005. All were proteinuric (mean 7.3 g/l, range 0.5-14.8 g/l) and 13 required dialysis within 1 month of diagnosis. Of the remaining seven, four developed end-stage renal failure after mean follow-up of 16 months (range 6-30). Nine died, with median survival of 19 months (range 1-62); all deaths were due to sepsis. DISCUSSION: Secondary AA amyloidosis is a serious complication of chronic soft tissue infection in intravenous drug users in central London. Affected individuals invariably presented with nephrotic range proteinuria and advanced renal failure. Treatment options are limited and the outcome for such patients on renal replacement was poor. Cross-disciplinary strategies are needed to prevent this serious complication of long-term intravenous drug abuse.
Authors: Chad Cooper; Jorge E Bilbao; Sarmad Said; Haider Alkhateeb; Jorge Bizet; Ahmed Elfar; Olinamyr Davalos; Ana T Meza; German T Hernandez Journal: J Nephropathol Date: 2013-07-01
Authors: Kanaan Mansoor; Murad Kheetan; Saba Shahnawaz; Anna P Shapiro; Eva Patton-Tackett; Larry Dial; Gary Rankin; Prasanna Santhanam; Antonios H Tzamaloukas; Tibor Nadasdy; Joseph I Shapiro; Zeid J Khitan Journal: BMC Nephrol Date: 2017-12-29 Impact factor: 2.388
Authors: M Harris; R Brathwaite; Catherine R McGowan; D Ciccarone; G Gilchrist; M McCusker; K O'Brien; J Dunn; J Scott; V Hope Journal: Harm Reduct J Date: 2018-05-08
Authors: Oliver Jung; Hans Stefan Haack; Maike Buettner; Christoph Betz; Christoph Stephan; Peter Gruetzmacher; Kerstin Amann; Markus Bickel Journal: BMC Nephrol Date: 2012-11-21 Impact factor: 2.388