REVIEWS   

Minerva Urologica e Nefrologica 2003 June;55(2):121-9

Copyright © 2003 EDIZIONI MINERVA MEDICA

language: English

Dialysis-related amyloidosis

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.