Dialysis-related Amyloidosis
People who have been on long term dialysis for kidney failure may develop dialysis-related amyloidosis.
This happens when a protein called beta2 microglobulin builds up in the blood because it is not completely removed either by haemodialysis or peritoneal dialysis.
What damage does dialysis amyloidosis do to the body?
This type of amyloidosis may affect the digestive system the heart and lungs but it most often affects the bones, joints and tendons (the tissues that connect muscle to bone). It can also cause bone cysts which can lead to bone fractures and tears in tendons and ligaments
Symptoms may include
- pain, stiffness and fluid in the joints.
- numbness or tingling, sometimes associated with muscle weakness, in the fingers and hands. (Carpel Tunnel syndrome)
The following tests may be used:
- Urinalysis and blood tests to detect the amount of amyloid proteins in urine and blood.
- X-rays and CT scans to provide pictures of bone cysts and amyloid deposits in bones, joints, tendons, and ligaments.
- Tests to show if heart or lungs are affected.
Treatment
There is no cure for dialysis-related amyloidosis but treatments may include:
- A successful kidney transplant in selected patient’s my stop the disease from progressing
- Newer, more effective hemodialysis filters
- Surgery may be needed to treat bone cysts, carpel tunnel and bone, joints and tendon problems
- Medication to control pain and inflammation.
Dialysis related amyloidosis has decreased with the use during dialysis of high-flux biocompatible membranes, which provide better clearance of beta2-m and are less likely to induce reactive inflammation.