The Japanese Journal of Clinical Dialysis Vol.13 No.9(3-1)

Theme Amyloid-Related Bone and Joint Derangements -- Clinical Diagnosis and Treatment
Title Blood purification for beta-2 microglobulin (beta2-MG) amyloidosis
Publish Date 1997/08
Author Yutaka Koda Kidney Center of Shinraku-En Hospital
[ Summary ] Clinical observations have revealed that beta2-MG amyloidosis is closely associated with patient age, dialytic years, dialysate purity, and dialysis membrane performance. High-performance membrane (HPM) dialyzers are reported to delay the onset of bone cysts, arthralgia and carpal tunnel syndrome due to dialysis amyloid. Large volume ultrafiltratoin therapy achieves superior beta2-MG removal and ameliorates disabled joint movement. On-line preparation of substitution fluid is economical and convenient but requires strict maintenance of dialysate purity. Beta2-MG removal with a new type of dialyzer in which internal ultrafiltration is significant, can be comparable to hemodiafiltration. It is still unclear whether or not CAPD is superior to hemodialysis in beta2-MG amyloid deposition, but basic conditions have features in common between the two. Convective therapy is anticipated to be widely accepted in the future.
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