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More than 5 Years Hemodialysis can Cause Amyloidosis

2012-09-26 17:36

We all know that amyloidosis is the fundamental cause of amyloid nephropathy and amyloidosis is generally divided into primary and secondary ones. Actually there is another type that is caused by long term hemodialysis (dialysis associated amyloidosis or beta-2-microglobulin amyloidosis). Of cause it can be said to belong to the secondary type.

Long term dialysis especially hemodialysis will cause the accumulation of beta-2-microglobulin which will often deposit in the synovial membrane and bones and cause cystic bone disease, traumatic arthrosis and carpal tunnel syndrome, but it is very rare that it will deposit in the internal organs.

1. Carpal tunnel syndrome. Patients suffer from pains, numbness and dyskinesia affecting one or both hands. Its incidence is low if the dialysis is less than 5 years. The incidence after 9 years’ dialysis is 13 times of those with 5 years’ dialysis and there is 100% chance if the hemodialysis has lasted for more than 17 years. There is beta-2-microglobulin deposition in carpal tunnel tissues, ulnar nerve and its surrounding tendons.

2. Amyloid arthritis. For patients that have underwent long term dialysis, the arthritis including shoulder, hip, knee, wrist, sternoclavicular joints, fingers, ankle, elbow, cervical vertebra and lumbar joint can all be involved. There will be pain, stiffness and functional limitation in the arthritis.

3. Pathological fracture. When cystic bone damages occur at the femoral head, femoral neck or acetabulum, there can be pathological fracture.

4. Extra-bone deposition of beta-2-microglobulin. Though it is very rare, beta-2-microglobulin can deposit in gastrointestinal tracts, heart, liver, spleen, lung, adrenal, prostate and testicles. Amyloid protein can be seen in the vascular wall of involved organs and tissues and there are different symptoms according to the sedimentary locations.

Besides amyloidosis, long term dialysis can also cause many other complications such as imbalance syndrome, arrhythmia, hemolysis, etc. Therefore patients should not only rely on dialysis or the kidney will become dependent on dialysis and the remaining functional nephrons will stop working after long term dialysis. And also there is a misunderstanding on dialysis that needs to be rectified. It used to be considered that dialysis can not be get rid of once started. Actually patients can get rid of dialysis so long as their kidney function is improved.


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