NDT Advance Access originally published online on December 18, 2008
Nephrology Dialysis Transplantation 2009 24(5):1593-1598; doi:10.1093/ndt/gfn706
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Characteristics of dialysis-related amyloidosis in patients on haemodialysis therapy for more than 30 years
1 Department of Blood Purification, Sangenjaya Hospital 2 Department of Blood Purification, Kidney Center, Tokyo Women's Medical University 3 Department of Orthopaedics, Okutsu Minimally Invasive Orthopaedic Clinic 4 Department of Medicine, Kidney Center, Tokyo Women's Medical University, Tokyo, Japan
Correspondence and offprint requests to: Shigeru Otsubo, Sangenjaya Hospital, 1-21-5 Sangenjaya, Setagaya-ku, Tokyo 154-0024, Japan. Tel: +81-3-3410-7321; Fax: +81-3-3410-7325; E-mail: sotsubo{at}kc.twmu.ac.jp
 |
Abstract |
|---|
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.
Keywords: amyloidosis; carpal tunnel syndrome; destructive spondyloarthropathy; high-flux membrane; long-term haemodialysis
Received for publication: 23. 7.08
Accepted in revised form: 24.11.08