| [ Summary ] |
Due to the present unphysiological artificial kidney systems, many complications such as bone/joint derangements are inevitable with long term treatment. Hyperparathyroidism is thought to be one of the causes of these derangements. However, carpal tunnel syndrome, trigger fingers, arthritis with synovitis, cystic lesions of periarticular bones, fluid retention bursitis, and destructive spondyloarthropathy are recognized as clinical manifestations of dialysis amyloidosis. The amyloid protein was identified as beta2-microglobulin (beta2-MG), which accumulates in the plasma of dialysis patients. Although the detail mechanisms of the genesis of amyloidosis from beta2-MG have not yet been fully clarified, a recent hypothesis regarding the role of modified beta2-MG with advanced glycation end products (AGEs) in the genesis of osteoarthropathy appears to be attractive. However, much remains to be solved in the field of clinical diagnosis and treatment of amyloid-related osteoarthropathy. |