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Dialysis-related amyloidosis: history and clinical manifestations

F Danesh1, L T Ho

  • 1Division of Nephrology/Hypertension, Northwestern University Medical School, Chicago, Illinois 60611-3008, USA.

Seminars in Dialysis
|March 27, 2001
PubMed

Insights

Dialysis-related amyloidosis (DRA), caused by beta(2)-microglobulin deposition in dialysis patients, leads to joint and organ complications. Current dialysis methods offer uncertain control over DRA incidence and progression.

Area of Science:

  • Nephrology
  • Rheumatology
  • Pathology

Background:

  • Dialysis-related amyloidosis (DRA), also known as beta(2)-microglobulin amyloidosis (A beta(2)M), affects patients with chronic renal disease and end-stage renal disease (ESRD).
  • DRA is linked to significant morbidity in long-term dialysis patients.
  • Beta(2)-microglobulin (beta(2)M) deposition in joints and osteoarticular surfaces causes characteristic symptoms, but a visceral form also exists.

Purpose of the Study:

  • To review the understanding of dialysis-related amyloidosis.
  • To discuss the clinical manifestations and pathology of A beta(2)M.
  • To evaluate the impact of current dialysis practices on DRA.

Main Methods:

  • Literature review of studies on dialysis-related amyloidosis.
  • Analysis of clinical findings and pathological descriptions of A beta(2)M.
  • Discussion of the role of beta(2)-microglobulin in amyloid formation.

Main Results:

  • DRA involves the deposition of beta(2)M, leading to joint and osteoarticular complications.
  • Systemic organ involvement (visceral form) has been reported.
  • The incidence and progression of DRA remain challenging to manage despite advances in dialysis.

Conclusions:

  • Dialysis-related amyloidosis presents unique challenges in ESRD patients.
  • Effective strategies to alter the incidence and course of DRA are still uncertain.
  • Further research is needed to improve the management of beta(2)-microglobulin amyloidosis.

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