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MINERVA UROLOGICA E NEFROLOGICA
A Journal on Nephrology and Urology
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,536
Minerva Urologica e Nefrologica 2003 June;55(2):121-9
Dzido G., Sprague S. M.
Department of Medicine Northwestern University Medical School Evanston Northwestern Healthcare Evanston, IL, USA
Dialysis-related amyloidosis (DRA) is a complication of long-term dialysis and can also be seen in patients with chronical renal failure and on continuous ambulatory peritoneal dyalisis. This review focuses on the chemical modifications of β2-microglobulin that lead to the formation and deposition of β2-amyloid fibrils in periarticular and articular sites which ultimately results in the clinical and radiographic characteristics of this devastating disease. Its most common manifestations are carpal tunnel syndrome, shoulder pain and destructive arthropathy. Treatment of DRA has been directed towards achieving normal serum levels of β2M in end stage renal disease (ESRD) patients which usually results in clinical improvement and delay in disease progression. Medical treatment consists of the use of corticosteroids and nonsteroidal anti-inflammatory drugs. Surgical intervention for carpal tunnel syndrome or spinal cord compression can greatly improve quality of life.