| [ Summary ] |
Dialysis-related amyloidosis is one important complication encounterd in patients receiving long term maintenance hemodialysis. Deposition is strongest in bone tissue, the peritendineum, arthroses and ligaments, but slight in other organs. Therefore, the clinical symptoms are mainly bone arthrosis symptoms caused by pathologic fractures, carpal tunnel syndrome, trigger finger, or destructive spondyloarthropathy, all related to amyloid osteoarthropathy. There is no specific blood based biochemical test. However, the existence of modified beta2-microglobulin (beta2-m) is important in amyloid deposition, and acidic beta2-m, lysine-specific cleavaged truncated beta2-m, and AGEs (advanced glycation end products)-beta2-m are reported. In addition, serum hyaluronic acid and ubiquitin levels are high in dialysis patients. These levels are correlated with carpal tunnel syndrome and shoulder arthralgia has also been reported. |