Regarding the Challenges of Amyloidosis Diagnosis and Typing in Ukraine

The files contain Supplementary Materials (Figures, Tables, Results, Methods) associated with the study "Regarding the Challenges of Amyloidosis Diagnosis and Typing in Ukraine".Classification of amyloid deposits is critical for prognosis and management of renal amyloidosis. This study presents a 10-year retrospective analysis of amyloidosis cases in adult patients from a single center in Ukraine, with a focus on diagnostic methods and the distribution of amyloid types. Amyloid-positive tissue biopsies from the kidney, buccal mucosa, gums, and abdominal fat were analyzed in 2013-2022. Amyloid deposits were classified using a multimodal approach with bright-field, fluorescence, and transmission electron microscopy. Among 13,477 adult nephrology patients, 1,217 underwent kidney biopsy, and 424 were evaluated with non-renal biopsies for systemic amyloidosis. Amyloid deposits were identified in 84 of 1,217 kidney biopsies, and in 147 of 424 non-renal biopsies. Of the patients diagnosed with renal amyloidosis, 94% presented with nephrotic syndrome, 31% with kidney failure. AL amyloidosis was the most common subtype identified, representing 61.5% of renal amyloidosis cases, in comparison with 16% accounting for the AA type. This study highlights a high prevalence of amyloidosis among patients in Ukraine compared to global estimates. The integration of proteomic analysis and genetic testing for amyloidosis is urgently needed to improve diagnostic accuracy and patient outcomes.