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      Continuous Ambulatory Peritoneal Dialysis in Familial Mediterranean Fever Amyloidosis Patients with End-Stage Renal Failure: A Single-Centre Experience from Turkey

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          Background/Aims: Familial Mediterranean fever (FMF) is an autosomal recessive disease characterised by recurrent fever attacks and polyserositis which may lead to the development of AA amyloidosis and end-stage renal disease (ESRD). In this study, we aimed to evaluate the efficacy of continuous ambulatory peritoneal dialysis (CAPD) in FMF-amyloidosis patients with ESRD. Methods: Forty age- and sex-matched patients undergoing CAPD at our centre between 1996 and 2002 were included in the study. Of these, 10 had FMF-amyloidosis, 10 had diabetes mellitus (DM), 10 had chronic glomerulonephritis (CGN) and 10 had chronic interstitial nephritis (CIN). Efficiency of CAPD, development of complications, presence of other diseases and survival were compared. Results: With the onset of ESRD, the frequency of FMF peritonitis attacks decreased, with less attacks occurring during CAPD in FMF-amyloidosis patients (p < 0.05). There was no significant difference between the FMF-amyloidosis group and other groups in terms of efficiency of CAPD, peritoneal function, complications and survival. DM patients had a shorter survival period compared with CGN and CIN patients (p < 0.05), but there was no survival difference between FMF-amyloidosis patients and other groups (p > 0.05). Conclusions: We conclude that CAPD is an effective and safe renal replacement therapy for FMF-amyloidosis patients with ESRD.

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          Most cited references 9

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          Colchicine in the prevention and treatment of the amyloidosis of familial Mediterranean fever.

           J Gafni,  M Pras,  S Cabili (1986)
          To determine whether colchicine prevents or ameliorates amyloidosis in patients with familial Mediterranean fever, we followed 1070 patients with the latter disease for 4 to 11 years after they were advised to take colchicine to prevent febrile attacks. Overall, at the end of the study, the prevalence of nephropathy was one third of that in a study conducted before colchicine was used to treat familial Mediterranean fever. Among 960 patients who initially had no evidence of amyloidosis, proteinuria appeared in 4 who adhered to the prophylactic schedule and in 16 of 54 who admitted non-compliance. Life-table analysis showed that the cumulative rate of proteinuria was 1.7 percent (90 percent confidence limits, 0.0 and 11.3 percent) after 11 years in the compliant patients and 48.9 percent (18.8 and 79.0 percent) after 9 years in the noncompliant patients (P less than 0.0001). A total of 110 patients had overt nephropathy when they started to take colchicine. Among 86 patients who had proteinuria but not the nephrotic syndrome, proteinuria resolved in 5 and stabilized in 68 (for more than eight years in 40). Renal function deteriorated in 13 of the patients with proteinuria and in all of the 24 patients with the nephrotic syndrome or uremia. We conclude that colchicine prevented amyloidosis in our high-risk population and that it can prevent additional deterioration of renal function in patients with amyloidosis who have proteinuria but not the nephrotic syndrome.
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            Familial Mediterranean fever

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              A controlled trial of colchicine in preventing attacks of familial mediterranean fever.


                Author and article information

                Nephron Clin Pract
                Nephron Clinical Practice
                S. Karger AG
                December 2004
                22 December 2004
                : 98
                : 4
                : c119-c123
                aDepartment of Nephrology, Cerrahpaşa Medical Faculty, University of İstanbul, İstanbul, and bDepartment of Rheumatology, Trakya Medical Faculty, University of Trakya, Edirne, Turkey
                81553 Nephron Clin Pract 2004;98:c119–c123
                © 2004 S. Karger AG, Basel

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                Figures: 1, Tables: 3, References: 19, Pages: 1
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