Is β2-microglobulin-related amyloidosis of hemodialysis patients a multifactorial disease? A new pathogenetic approach

G. Cianciolo, L. Colì, G. La Manna, G. Donati, F. D'Addio, G. Comai, D. Ricci, A. Dormi, M. Wratten, G. Feliciangeli, Sergio Stefoni

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Purpose: β2-microglobulin amyloidosis (Aβ2M) is one of the main long-term complications of dialysis treatment. The incidence and the onset of Aβ2M has been related to membrane composition and/or dialysis technique, with non-homogeneous results. This study was carried out to detect: i) the incidence of bone cysts and CTS from Aβ2M; ii) the difference in Aβ 2M onset between cellulosic and synthetic membranes; iii) other risk factors besides the membrane. Methods: 480 HD patients were selected between 1986 to 2005 and grouped according to the 4 types of membranes used (cellulose, synthetically modified cellulose, synthetic low-flux, synthetic high-flux). The patients were analyzed before and after 1995, when the reverse osmosis treatment for dialysis water was started at our center, and the incidence of Aβ2M was compared between the two periods. Routine plain radiography, computer tomography (CT) and nuclear magnetic resonance imaging (MRI) as well as electromyography were used to investigate the clinical symptoms. Results: Bone cysts occurred in 29.2% of patients before 1995 vs. 12.2% after 1995 (p2M. Conclusions: The findings that the inflammatory status as well as low albumin and the residual GFR of the uremic patient are predictive of Aβ2M lesions suggests that Aβ2M has a multifactorial origin rather than being solely a membrane- or technique-related side effect.

Original languageEnglish
Pages (from-to)864-878
Number of pages15
JournalInternational Journal of Artificial Organs
Volume30
Issue number10
Publication statusPublished - Oct 2007

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Amyloidosis
Renal Dialysis
Dialysis
Membranes
Bone Cysts
Cellulose
Incidence
Bone
Fluxes
Osmosis
Electromyography
Water Purification
Radiography
Reverse osmosis
Tomography
Albumins
Magnetic Resonance Spectroscopy
Magnetic Resonance Imaging
Nuclear magnetic resonance
Imaging techniques

Keywords

  • β2-microglobulin amyloidosis
  • Bone cysts
  • Carpal tunnel syndrom
  • Cellulosic membranes
  • Dialysis
  • Synthetic membranes

ASJC Scopus subject areas

  • Biophysics

Cite this

Is β2-microglobulin-related amyloidosis of hemodialysis patients a multifactorial disease? A new pathogenetic approach. / Cianciolo, G.; Colì, L.; La Manna, G.; Donati, G.; D'Addio, F.; Comai, G.; Ricci, D.; Dormi, A.; Wratten, M.; Feliciangeli, G.; Stefoni, Sergio.

In: International Journal of Artificial Organs, Vol. 30, No. 10, 10.2007, p. 864-878.

Research output: Contribution to journalArticle

Cianciolo, G, Colì, L, La Manna, G, Donati, G, D'Addio, F, Comai, G, Ricci, D, Dormi, A, Wratten, M, Feliciangeli, G & Stefoni, S 2007, 'Is β2-microglobulin-related amyloidosis of hemodialysis patients a multifactorial disease? A new pathogenetic approach', International Journal of Artificial Organs, vol. 30, no. 10, pp. 864-878.
Cianciolo, G. ; Colì, L. ; La Manna, G. ; Donati, G. ; D'Addio, F. ; Comai, G. ; Ricci, D. ; Dormi, A. ; Wratten, M. ; Feliciangeli, G. ; Stefoni, Sergio. / Is β2-microglobulin-related amyloidosis of hemodialysis patients a multifactorial disease? A new pathogenetic approach. In: International Journal of Artificial Organs. 2007 ; Vol. 30, No. 10. pp. 864-878.
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AU - Donati, G.

AU - D'Addio, F.

AU - Comai, G.

AU - Ricci, D.

AU - Dormi, A.

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AU - Stefoni, Sergio

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AB - Purpose: β2-microglobulin amyloidosis (Aβ2M) is one of the main long-term complications of dialysis treatment. The incidence and the onset of Aβ2M has been related to membrane composition and/or dialysis technique, with non-homogeneous results. This study was carried out to detect: i) the incidence of bone cysts and CTS from Aβ2M; ii) the difference in Aβ 2M onset between cellulosic and synthetic membranes; iii) other risk factors besides the membrane. Methods: 480 HD patients were selected between 1986 to 2005 and grouped according to the 4 types of membranes used (cellulose, synthetically modified cellulose, synthetic low-flux, synthetic high-flux). The patients were analyzed before and after 1995, when the reverse osmosis treatment for dialysis water was started at our center, and the incidence of Aβ2M was compared between the two periods. Routine plain radiography, computer tomography (CT) and nuclear magnetic resonance imaging (MRI) as well as electromyography were used to investigate the clinical symptoms. Results: Bone cysts occurred in 29.2% of patients before 1995 vs. 12.2% after 1995 (p2M. Conclusions: The findings that the inflammatory status as well as low albumin and the residual GFR of the uremic patient are predictive of Aβ2M lesions suggests that Aβ2M has a multifactorial origin rather than being solely a membrane- or technique-related side effect.

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