An injecting drug user may develop renal amyloidosis.
Type of amyloid: serum amyloid A (AA, an acute phase reactant)
Clinical features:
(1) long-term injection drug use with a source of chronic inflammation, typically chronic or recurring infections
(2) chronic elevation of inflammatory markers (ESR, CRP)
(3) variable renal disease (see below)
(3) variable involvement of other organs with amyloid (gastrointestinal tract, skin, other)
(4) elevated amyloid A
Renal manifestations of AA amyloidosis may include:
(1) nephrogenic diabetes insipidus
(2) renal tubular acidosis
(3) proteinuria with or without the nephrotic syndrome
(4) progressive renal failure
