Influence of dialysis membranes on the development of dialysis associated osteoarthropathy

The influence of the dialysis membrane and the patients' ages on the development of dialysis osteoarthropathy was studied in 25 patients who had been on hemodialysis for more than 10 years. The patients were dialyzed with cuprophane membranes, and then treated with polyacrylonitrile AN 69. Radiolucent bone cysts (at least 5 mm in diameter in the wrists and at least 10 mm in the shoulders or hips) were evaluated by X-ray and confirmed by CT scan. The patients with bone cysts (N = 9) had been exposed significantly more to cuprophane dialysis and significantly less to AN 69 dialysis than the patients without bone cysts (N = 16). There was no significant difference in the total duration of dialysis between the two groups. The average age was significantly greater in patients with bone cysts than in patients without bone cysts. The severity of the cystic bone lesions correlated positively with the patient's age and the duration of dialysis using cuprophane membranes, and negatively with the duration of dialysis using AN 69. These findings suggest that the development of dialysis osteoarthropathy may be related to both age and the use of cuprophane membranes. Hemodialysis using AN 69 may prevent, or at least postpone the development of dialysis amyloidosis.