{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T23:55:45Z","timestamp":1761177345317,"version":"build-2065373602"},"reference-count":0,"publisher":"Oxford University Press (OUP)","issue":"Supplement_3","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,21]]},"abstract":"Abstract<\/jats:title>\n \n Background and Aims<\/jats:title>\n ATTR V30M amyloidosis is a rare hereditary disease characterized by the deposition of transthyretin (TTR), commonly leading to chronic kidney disease (CKD) and heart failure. Technetium-99m-3,3-diphosphono-1,2-propanodicarboxylic acid (DPD) scintigraphy is crucial for non-invasive cardiac amyloidosis (CA) diagnosis. However, amyloid fibril composition appears to influence its sensitivity. This study aims to clarify possible shadowed kidney-heart interfaces, unravelling future therapeutic approaches.<\/jats:p>\n <\/jats:sec>\n \n Method<\/jats:title>\n We retrospectively analyzed ATTRV30M patients followed by nephrologists at a single centre from 2014 to 2025; 111 cases who underwent DPD scintigraphy and echocardiography were included; DPD images were reviewed based on visual scoring Perugini method. Diagnostic criteria for CA: interventricular septal thickening \u226512 mm (without other cause) or a Perugini score \u22652 (positive DPD), besides no plasma cell disease. The cardiorenal assessment was established on the National Amyloidosis Centre (NAC) staging system, based on N-terminal pro-B-type natriuretic peptide (NT-proBNP) and estimated glomerular filtration rate (eGFR): stage 1, NT-proBNP \u22643000 ng\/L and eGFR \u226545 ml\/min; stage 3, NT-proBNP &gt;3000 ng\/L and eGFR &lt;45 ml\/min; stage 2, remainder. eGFR was calculated using the CKD-EPI creatinine-cystatin equation (2021).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n 49 (44%) patients had no evidence of CA, the majority women (71%) having developed the first symptoms of the disease, mainly neuropathy, at 34 yo, median. Non-CA cases showed low NAC scores (77%), however males accounted for half of NAC stages 2 or 3, mainly due to higher rates (29%) of end-stage kidney disease (ESKD), compared to women (6%). Among the 62 CA subjects, 43 scored Perugini 0 or 1 (non-positive) at DPD scintigraphy, with its sensitivity being particularly low (11%) in patients with early-onset disease (&lt;50 yo) versus moderate (61%) in the older ones. Non-positive DPD subsets had a 1:1 ratio in sex and liver transplant (LT), in contrast to positive-DPD cases, who were predominantly males (84.2%) and had not received LT (78.9%). NAC scores were higher in non-positive versus positive DPD CA patients (P\u00a0=\u00a00.009). Table\u00a01 furthers the main cardiorenal features among three main CA phenotypes, based on gender and DPD results, highlighting a higher serum cystatin c\/creatinine ratio and an uneven kidney function stages distribution in women with non-positive DPD compared to men. Overall, 19 (17%) patients died during a median follow-up of 42 months. Mortality increased 5 times in patients with abnormal NAC score (P\u00a0=\u00a00.002) and 4 fold if non-positive DPD CA was present (P\u00a0=\u00a00.028).<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Our study reinforces the ATTRV30M amyloidosis systemic spectrum, merging kidney and heart nuances into potentially new phenotypes, according to DPD scintigraphy. When faced with suggestive echocardiographic features of CA but non-positive DPD results, estimation of kidney function with combined creatinine-cystatin c equation may help detect cardiorenal syndrome earlier, namely in women, guiding therapeutics.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/ndt\/gfaf116.1405","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T10:44:57Z","timestamp":1761129897000},"source":"Crossref","is-referenced-by-count":0,"title":["#3571 ATTR V30M amyloidosis and kidney-heart axis: how DPD-scan cover a misleading interpretation"],"prefix":"10.1093","volume":"40","author":[{"given":"Jos\u00e9 Pedro","family":"Escaleira","sequence":"first","affiliation":[{"name":"Unidade Local de Sa\u00fade (ULS) de Santo Ant\u00f3nio, Porto, Portugal Department of Nuclear Medicine,"},{"name":"Unit for Multidisciplinary Research in Biomedicine (UMIB), Porto, Portugal"}]},{"given":"Jo\u00e3o","family":"Bessa","sequence":"additional","affiliation":[{"name":"ULS de Santo Ant\u00f3nio, Porto, Portugal Department of Nephrology,"}]},{"given":"Andreia","family":"Campos","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade (ULS) de Santo Ant\u00f3nio, Porto, Portugal Department of Nuclear Medicine,"}]},{"given":"Ana","family":"Cunha","sequence":"additional","affiliation":[{"name":"ULS de Santo Ant\u00f3nio, Porto, Portugal Department of Nephrology,"}]},{"given":"Patr\u00edcia","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Unit for Multidisciplinary Research in Biomedicine (UMIB), Porto, Portugal"},{"name":"School of Medicine and Biomedical Sciences (ICBAS), University of Porto (UP), Porto, Portugal"},{"name":"Unidade Corino de Andrade, ULS Santo Ant\u00f3nio, Porto, Portugal"},{"name":"ULS de Santo Ant\u00f3nio, Porto, Portugal Department of Cardiology,"}]},{"given":"L\u00facia","family":"Costa","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade (ULS) de Santo Ant\u00f3nio, Porto, Portugal Department of Nuclear Medicine,"}]},{"given":"Josefina","family":"Santos","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade (ULS) de Santo Ant\u00f3nio, Porto, Portugal Department of Nuclear Medicine,"}]},{"given":"Lu\u00edsa Correia Lopes","family":"Lobato","sequence":"additional","affiliation":[{"name":"Unit for Multidisciplinary Research in Biomedicine (UMIB), Porto, Portugal"},{"name":"ULS de Santo Ant\u00f3nio, Porto, Portugal Department of Nephrology,"},{"name":"School of Medicine and Biomedical Sciences (ICBAS), University of Porto (UP), Porto, Portugal"},{"name":"Unidade Corino de Andrade, ULS Santo Ant\u00f3nio, Porto, Portugal"},{"name":"Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal"}]}],"member":"286","published-online":{"date-parts":[[2025,10,21]]},"container-title":["Nephrology Dialysis Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ndt\/article-pdf\/40\/Supplement_3\/gfaf116.1405\/64846501\/gfaf116.1405.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ndt\/article-pdf\/40\/Supplement_3\/gfaf116.1405\/64846501\/gfaf116.1405.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T11:01:29Z","timestamp":1761130889000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ndt\/article\/doi\/10.1093\/ndt\/gfaf116.1405\/8295797"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":0,"journal-issue":{"issue":"Supplement_3","published-online":{"date-parts":[[2025,10,21]]},"published-print":{"date-parts":[[2025,10,21]]}},"URL":"https:\/\/doi.org\/10.1093\/ndt\/gfaf116.1405","relation":{},"ISSN":["0931-0509","1460-2385"],"issn-type":[{"value":"0931-0509","type":"print"},{"value":"1460-2385","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,10]]},"published":{"date-parts":[[2025,10]]},"article-number":"gfaf116.1405"}}