Haemodialysis-associated amyloidosis


Amyloidosis is the accumulation on misfolded protein fibers in the body. This is very common condition associated with many of the chronic illness. Haemodialysis-associated amyloidosis is a form of systemic amyloidosis associated with chronic kidney failure.[1] Even if this is common in CKD patients with chronic regular dialysis, it can be also seen in patient with CKD but have never dialysed too.[2]

Haemodialysis-associated amyloidosis
SpecialtyImmunology 

Presentation

Long-term haemodialysis results in a gradual accumulation of β2 microglobulin, a serum protein, in the blood.[3] It accumulates because it is unable to cross the dialysis filter.

Affected individuals usually present after 5 years of dialysis rarely before that. The tendency of haemodialysis-associated amyloidosis is to be articular in general affecting the joints.

Diagnosis

Prevention

The mainstay of management of the dialysis related amyloidosis is the prevention than the other type of treatment methods. Because most of the medical and surgical managements for this condition may not prevent the symptoms completely. Therefore we have to take adequate precautions to prevent future dialysis disequilibrium syndrome in CKD patients.

There are several steps in prevention of dialysis related amyloidosis.[4]

  • Use of high flux dialyzers
  • Use of Beta 2 globulin absorber
  • Preserve the residual kidney functions
  • Early kidney transplant


In addition low copper dialysis is theorized to prevent or delay onset.[5]

Management

Management of haemodialysis associated amyloidosis is symptomatic. Although there are lot of methods to prevent and delay the complications, probably the steroids and analgesics may helpful in the management of the condition.

However there are some surgical procedure to reduce the pain.

See also

References
  1. Miyata T, Oda O, Inagi R, et al. (September 1993). "beta 2-Microglobulin modified with advanced glycation end products is a major component of hemodialysis-associated amyloidosis". J. Clin. Invest. 92 (3): 1243–52. doi:10.1172/JCI116696. PMC 288264. PMID 8376584.
  2. Morinie`re P, Marie A, Esper NE et al. Destructive spondylarthropathy with b2-microglobulin deposits in a uremic patient before chronic hemodialysis. Nephron 1991; 59: 654–657
  3. Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 978-1-4160-2999-1.
  4. "Dialysis Related Amyloidosis".
  5. "BU Amyloid Treatment & Research Program". Archived from the original on 2008-07-20.

https://academic.oup.com/ndt/article-pdf/13/suppl_1/58/9896967/130058.pdf


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