| Theme |
The appropriate management for CKD-MBD in the elderly patients |
| Title |
The osteoarthropathy of hemodialysis-related amyloidosis |
| Author |
Masahiro Kawada |
Nephrology Center, Toranomon Hospital |
| Author |
Yoshifumi Ubara |
Nephrology Center, Toranomon Hospital |
| Author |
Kenmei Takaichi |
Nephrology Center, Toranomon Hospital |
| [ Summary ] |
Hemodialysis-related amyloidosis (HDA) is a systemic amyloidosis consisting of amyloid protein for which #946;2-microglobulin (#946;2MG) is the precursor protein. Although the time to onset has been delayed by recent improvements in dialysis treatment, osteoarthropathy remains one of the main complications. The mechanism of HDA has not been elucidated, and a method has not been found to remove amyloid deposits ; however, we are able to delay the onset of HDA by reducing the risk factors. Methods such as use of biocompatible polysulfone and polymethylmethacrylate membranes, use of high-flux membranes, purification of the dialysate, changing to hemodiafiltration or hemofiltration, and use of a #946;2MG adsorption column, are effective in delaying the onset of HDA. Age is one of the risk factors for HDA, and dialysis patients are older than those in the past ; therefore,diminished activities of daily living (ADLs) and a poor quality of life (QOL) due to the osteoarthropathy of HDA will become problems to be resolved in the future. Aggressive approaches are needed for HDA. |