Kidney Week

Abstract: SA-PO0837

Natural History and Post-Transplant Outcomes Among Patients with Kidney Leukocyte Cell-Derived Chemotaxin 2-Associated Amyloidosis

Session Information

• Glomerular Diseases: Management, Evolving Strategies, and Practice-Changing Advances
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Lopez-Gutierrez, Pedro A., University of New Mexico, Department of Internal Medicine, Nephrology, Albuquerque, New Mexico, United States

Pedro A. Lopez-Gutierrez, MD

• Munawar Ali, Iqra Fatima Fm, Aga Khan University, Karachi, Sindh, Pakistan

Iqra Fatima Fm Munawar Ali, MD, MBBS

• Iftikhar, Nimra, University of New Mexico, Department of Internal Medicine, Nephrology, Albuquerque, New Mexico, United States

Nimra Iftikhar, MD

• Hanson, Valeria, University of New Mexico, Department of Internal Medicine, Nephrology, Albuquerque, New Mexico, United States

Valeria Hanson, MD

• Afrin, Shumaila, University of Texas Southwestern, Dallas, Texas, United States

Shumaila Afrin, PhD

• Saelices Gomez, Lorena, University of Texas Southwestern, Dallas, Texas, United States

Lorena Saelices Gomez, PhD

• Argyropoulos, Christos, University of New Mexico, Department of Internal Medicine, Nephrology, Albuquerque, New Mexico, United States

Christos Argyropoulos, MD, MS, MSc, PhD, FASN

• Garcia, Pablo, University of New Mexico, Department of Internal Medicine, Nephrology, Albuquerque, New Mexico, United States

Pablo Garcia, MD, MS, FASN

Background

ALECT2 is the third most common cause of renal amyloidosis in the United States, with a strong predilection for Hispanic patients in the Southwest. (PMID:24522497) Despite its regional prevalence, the data on the trajectory of kidney function decline and post-transplant outcomes remain poorly characterized.

Methods

This is a retrospective study of patients diagnosed with ALECT2 by kidney biopsy at UNM from January 2014 to April 2024. Pre- and post-biopsy eGFR trajectories and post-transplant allograft function were analyzed.

Results

12 patients had pre-biopsy data available, with the mean age at diagnosis 64± 12.0 years, 8(67%) were females, and 8 identified as Hispanic. Mean eGFR at diagnosis was 31 (SD 29) indicating advanced kidney disease with 67% diagnosed as CKD stage 4 or 5. Concomitant kidney pathology was identified in 50% with diabetic nephropathy being present in 2/3 of those. A significant change in the eGFR trajectory identified at the time of biopsy through change point analysis [Figures A,C,D] Among four patients who underwent kidney transplantation, allograft eGFR remained stable over more than 60 months of follow-up [Figure D]

Conclusion

In this cohort of predominantly Hispanic patients, ALECT2 amyloidosis presented with advanced CKD and accelerated loss of kidney function, which prompted a biopsy that detected the disease. Post-transplant allograft function was well maintained, supporting kidney transplantation as a viable treatment strategy for ALECT2-associated kidney disease.

Baseline Characteristics