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OBJEcTIVE: Amyloidosis is a chronic disease associated with proteinuria and can progress to renal failure. The diagnosis and treatment of the underlying cause is therefore important. In this study at a university hospital, the diagnosis of amyloidosis patients with renal biopsies was evaluated retrospectively. MATERIAL and METhODS: 69 (42 males, 27 females, mean age: 51.7 ± 14.8 years) patients were diagnosed with amyloidosis with renal biopsy. Indications for biopsy was nephrotic syndrome in 42 patients (60.9%), nephritic syndrome in 27 (39.1%) and renal dysfunction with proteinuria in 31 (44.9%). RESULTS: The most common causes of secondary amyloidosis were Familial Mediterranean Fever in 17 of the 62 patients, chronic inflammatory diseases in 17 patients and chronic infection in 13 patients. No cause was determined in 12 patients. Multiple myeloma was present in 5 patients with primary amyloidosis. At the time of diagnosis with amyloidosis, 19 patients were stage 1, 15 stage 2, 5 stage 3A, 12 stage 3B, 10 stage 4 and 8 stage 5. The baseline hemoglobin, serum albumin, creatinine, sodium, potassium, calcium, phosphorus, AST, ALT, PTH, SAA, CRP levels, average daily urinary protein excretion and baseline GFR values were not significantly different in primary and secondary amyloidosis patients. The treatment was medical in 62.3% of the patients, dialysis in 31.9% and renal transplantation in 5.8%.

We described the clinical course of 4 patients with acute kidney injury (AKI) in whom kidney function improvement was delayed because of concomitant hypothyroidism. After initiating thyroid hormone replacement therapy, the kidney function improved partially or completely. We discussed the underlying possible pathophysiological mechanisms of delayed recovery. A 33-year-old female presented with kidney failure following severe preeclampsia. She was diagnosed with hypothyroidism. The second case was a 70-year-old male who was healthy previously, and presented with elevated serum creatinine. The third patient was a 72-year-old female, who was admitted with non-oliguric AKI associated with aminoglycoside and non-steroid anti-inflammatory drug exposure. The fourth patient was a 60-yearold female under amiodarone treatment after coronary bypass grafting who presented with fatigue, and AKI. We suggest that delayed recovery of kidney dysfunction might be associated with hypothyroidism that prevents regeneration of tubular cells.