Dialysis-related amyloidosis: a review from case series

Abstract In Japan, dialysis first started in 1963 with intermittent peritoneal dialysis, followed by hemodialysis in 1966. The introduction of dialysis made it possible to treat end-stage renal failure, which at that time was a fatal or malignant disease, making it a benign disease and enabling long...

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Main Authors: Yoshifumi Ubara, Tatsuya Suwabe, Takehiko Wada, Naoki Sawa
Format: Article
Language:English
Published: BMC 2025-02-01
Series:Renal Replacement Therapy
Subjects:
Online Access:https://doi.org/10.1186/s41100-025-00606-x
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author Yoshifumi Ubara
Tatsuya Suwabe
Takehiko Wada
Naoki Sawa
author_facet Yoshifumi Ubara
Tatsuya Suwabe
Takehiko Wada
Naoki Sawa
author_sort Yoshifumi Ubara
collection DOAJ
description Abstract In Japan, dialysis first started in 1963 with intermittent peritoneal dialysis, followed by hemodialysis in 1966. The introduction of dialysis made it possible to treat end-stage renal failure, which at that time was a fatal or malignant disease, making it a benign disease and enabling long-term survival. However, patients who survived on dialysis for more than 10 years often developed dialysis-related amyloidosis (DRA), a serious dialysis complication that causes bone and joint lesions such as carpal tunnel syndrome, cervical destructive spondyloarthropathy (DSA), and lumbar DSA. DRA led to impaired activities of daily living (ADL) and quality of life (QOL), and ultimately, death. Because DRA was caused by the deposition of beta-2 microglobulin (β2MG), treatment methods were devised to remove serum β2MG, i.e., dialysis fluid was purified, dialyzers with dialysis membranes were developed, and hemodiafiltration was introduced. These approaches not only greatly reduced the β2MG concentration in the blood, but they also significantly increased the number of years until the onset of DRA and decreased the amount of deposited amyloid. Unfortunately, continuous ambulatory peritoneal dialysis (CAPD) removes less β2MG than hemodialysis and patients who undergo CAPD for more than ten years can develop lumbar DSA, which decreases their ADL and can cause death. This article describes the history of treatment of dialysis amyloidosis at our hospital, a pioneering institution for dialysis in Japan, with reference to relevant publications.
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issn 2059-1381
language English
publishDate 2025-02-01
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series Renal Replacement Therapy
spelling doaj-art-252d657718ac4a93934de828fa47ed452025-08-20T03:03:23ZengBMCRenal Replacement Therapy2059-13812025-02-0111111210.1186/s41100-025-00606-xDialysis-related amyloidosis: a review from case seriesYoshifumi Ubara0Tatsuya Suwabe1Takehiko Wada2Naoki Sawa3Nephrology Center and Okinaka Memorial Institute for Medical Research, Toranomon HospitalNephrology Center and Okinaka Memorial Institute for Medical Research, Toranomon HospitalNephrology Center and Okinaka Memorial Institute for Medical Research, Toranomon HospitalNephrology Center and Okinaka Memorial Institute for Medical Research, Toranomon HospitalAbstract In Japan, dialysis first started in 1963 with intermittent peritoneal dialysis, followed by hemodialysis in 1966. The introduction of dialysis made it possible to treat end-stage renal failure, which at that time was a fatal or malignant disease, making it a benign disease and enabling long-term survival. However, patients who survived on dialysis for more than 10 years often developed dialysis-related amyloidosis (DRA), a serious dialysis complication that causes bone and joint lesions such as carpal tunnel syndrome, cervical destructive spondyloarthropathy (DSA), and lumbar DSA. DRA led to impaired activities of daily living (ADL) and quality of life (QOL), and ultimately, death. Because DRA was caused by the deposition of beta-2 microglobulin (β2MG), treatment methods were devised to remove serum β2MG, i.e., dialysis fluid was purified, dialyzers with dialysis membranes were developed, and hemodiafiltration was introduced. These approaches not only greatly reduced the β2MG concentration in the blood, but they also significantly increased the number of years until the onset of DRA and decreased the amount of deposited amyloid. Unfortunately, continuous ambulatory peritoneal dialysis (CAPD) removes less β2MG than hemodialysis and patients who undergo CAPD for more than ten years can develop lumbar DSA, which decreases their ADL and can cause death. This article describes the history of treatment of dialysis amyloidosis at our hospital, a pioneering institution for dialysis in Japan, with reference to relevant publications.https://doi.org/10.1186/s41100-025-00606-xHemodialysis (HD)Dialysis-related amyloidosis (DRA)Destructive spondyloarthropathy (DSA)
spellingShingle Yoshifumi Ubara
Tatsuya Suwabe
Takehiko Wada
Naoki Sawa
Dialysis-related amyloidosis: a review from case series
Renal Replacement Therapy
Hemodialysis (HD)
Dialysis-related amyloidosis (DRA)
Destructive spondyloarthropathy (DSA)
title Dialysis-related amyloidosis: a review from case series
title_full Dialysis-related amyloidosis: a review from case series
title_fullStr Dialysis-related amyloidosis: a review from case series
title_full_unstemmed Dialysis-related amyloidosis: a review from case series
title_short Dialysis-related amyloidosis: a review from case series
title_sort dialysis related amyloidosis a review from case series
topic Hemodialysis (HD)
Dialysis-related amyloidosis (DRA)
Destructive spondyloarthropathy (DSA)
url https://doi.org/10.1186/s41100-025-00606-x
work_keys_str_mv AT yoshifumiubara dialysisrelatedamyloidosisareviewfromcaseseries
AT tatsuyasuwabe dialysisrelatedamyloidosisareviewfromcaseseries
AT takehikowada dialysisrelatedamyloidosisareviewfromcaseseries
AT naokisawa dialysisrelatedamyloidosisareviewfromcaseseries