[Dialysis-associated amyloidosis. Part 1: Biochemistry, clinical aspects, roentgen morphology]

Dialysis-related amyloidosis is characterized clinically by the carpal tunnel syndrome, pain and swelling of joints. These alterations are due to amyloid deposits in the carpal tunnel, in the synovia, ligaments and bones. It has been shown that beta 2m is the major component of this amyloidosis. Serum and urine concentration of beta 2m are markedly elevated in chronic renal failure due to failure of filtration and lack of metabolism by the renal tubular epithelium. beta 2m-derived amyloid is identified by immunohistochemistry using antibodies derived against beta 2m. Radiology shows cyst-like periarticular bone defects, destructive arthropathy and spondylarthropathy.