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[Amyloidosis associated with dialysis]

J Mátyus1, G Kakuk

  • 1Debreceni Orvostudományi Egyetem, I. Belklinika.

Orvosi Hetilap
|March 12, 1995
PubMed
Summary
This summary is machine-generated.

Dialysis-related amyloidosis, caused by beta 2-microglobulin buildup, affects long-term dialysis patients. Early diagnosis and improved dialysis strategies, including biocompatible membranes, can prevent and manage this complication.

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Area of Science:

  • Nephrology
  • Biochemistry
  • Pathology

Context:

  • Dialysis-related amyloidosis (DRA) is a significant complication in patients undergoing long-term hemodialysis.
  • Elevated serum beta 2-microglobulin (β2M) levels in uremia are primarily due to impaired clearance.
  • The pathogenesis of β2M deposition is multifactorial, involving membrane bioincompatibility and dialysate endotoxins.

Purpose:

  • To review the pathogenesis, clinical manifestations, diagnosis, and management of dialysis-related amyloidosis.
  • To highlight the role of beta 2-microglobulin in the development of DRA.
  • To discuss current and future strategies for preventing and treating this condition.

Summary:

  • Beta 2-microglobulin amyloidosis primarily affects periarticular and perineural tissues, leading to carpal tunnel syndrome and symmetrical joint arthropathy.

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  • While visceral organ involvement is less common, subchondral bone cysts and spondylarthropathy can cause pathological fractures and neurological complications.
  • Diagnosis involves imaging and immunohistology, with improved dialysis strategies and renal transplantation offering therapeutic benefits.

    • Impact:

    • Optimizing dialysis membranes and water purity can prevent or slow the progression of DRA.
    • Early diagnosis and intervention, including surgical options, are crucial for managing symptoms and complications.
    • Renal transplantation is a successful treatment, but pre-existing amyloid depositions require ongoing consideration.