Characteristics of dialysis-related amyloidosis in patients on haemodialysis therapy for more than 30 years

• Published in: Nephrology, dialysis, transplantation Vol. 24; no. 5; pp. 1593 - 1598
• Main Authors: Otsubo, Shigeru, Kimata, Naoki, Okutsu, Ichiro, Oshikawa, Kazunori, Ueda, Syuitsu, Sugimoto, Hisayuki, Mitobe, Michihiro, Uchida, Keiko, Otsubo, Kimiko, Nitta, Kosaku, Akiba, Takashi
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.05.2009; Oxford Publishing Limited (England)
• Subjects: Aged; amyloidosis; Amyloidosis - etiology; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; carpal tunnel syndrome; Carpal Tunnel Syndrome - etiology; Carpal Tunnel Syndrome - surgery; Chronic Disease; destructive spondyloarthropathy; Emergency and intensive care: renal failure. Dialysis management; Female; high-flux membrane; Humans; Intensive care medicine; Kidney Diseases - therapy; long-term haemodialysis; Longitudinal Studies; Male; Medical sciences; Middle Aged; Renal Dialysis - adverse effects; Spondylarthropathies - etiology; Spondylarthropathies - surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Trigger Finger Disorder - etiology; Trigger Finger Disorder - surgery; carpal tunnel syndrome; destructive spondyloarthropathy; high-flux membrane; long-term haemodialysis; amyloidosis; Kidney disease; Human; Carpal tunnel syndrome; Nervous system diseases; Compression; Urinary system disease; Hemodialysis; Diseases of the osteoarticular system; Metabolic diseases; Enzymopathy; Protein; Extrarenal dialysis; Treatment; Renal failure; Amyloidosis; Dialysis; Peripheral nerve disease
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/gfn706

Background. Dialysis-related amyloidosis is one of the chronic the complications of haemodialysis. We conducted an investigation of dialysis-associated amyloidosis in extremely long-term survivors. Methods. Twenty-one patients on haemodialysis for more than 30 years (‘30+’ group) and 13 patients on haemodialysis for 20–30 years (‘20–30’ group) at Sangenjaya Hospital were enrolled in this study. The frequencies of operations for conditions related to haemodialysis-related amyloidosis were examined. Results. The mean age at the start of haemodialysis was younger in the ‘30+’ group (29.1 ± 7.3 years) than in the ‘20–30’ group (40.5 ± 8.2 years, P = 0.0003). Eighteen (85.7%) patients had undergone surgery for CTS, six (28.6%) had undergone surgery for trigger finger and six (28.6%) had undergone surgery for cervical destructive spondyloarthropathy (DSA) at 30 years after the start of haemodialysis therapy. Patients who were over the age of 30 years at the start of dialysis therapy more frequently underwent CTS operations (100%) than those who were under 30 years of age at the start of dialysis (76.9%; P = 0.025) in the ‘30+’ group at 30 years after the start of haemodialysis. The frequencies of operations for CTS did not differ significantly between the ‘20–30’ group and the ‘30+’ group. Conclusions.Haemodialysis-associated amyloidosis was common in extremely long-term survivors. Even though the mean age at the start of haemodialysis was younger in the ‘30+’ group than in the ‘20–30’ group, the frequency of operations for CTS did not differ. This may be attributable to the recent advances in haemodialysis technologies.