Summary
Amyloidosis containing β2 microglobulin (β2m) and joint pains are frequent complications of long-term hemodialysis. In a prospective study the authors planned to act on dialysis arthropathies (DA) by improving β2m depuration: for 8 patients suffering from DA we replaced usual cuprophane membranes (CU) by high permeability polyacrylonitrile membranes (PAN). DA was diagnosed on the presence of severe disabling arthralgias in the absence of any other obvious etiology, and on the presence of at least 3 among 6 criteria. The efficacy of the switch of DM was assessed on 6 criteria including the patient's own evaluation at the end of the study and a joint pain severity index. Clinical evaluation and β2m measurement were carried out at the start of the trial and after a mean duration of dialysis on PAN of 6 months. An improvement in joint symptomatology and a decrease of joint severity index were noted in the 8 cases. Our results suggest that the change of DM has a favorable influence on DA. This improvement could result either from a better β2m depuration or from a better biocompatibility of PAN than the CU previously used.
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Amadori, A., Candi, P., Sasdelli, M., Massai, G., Favilla, S., Passaleva, A., Ricci, M. Hemodialysis leukopenia and complement function with different dialyzers. Kidney Int, 1983, 24, 775–781.
Bardin, T., Kuntz, D., Zingraff J., Voisin, M.C., Zelmar, A., Lansaman, J.: Synovial amyloidosis in patients undergoing long-term hemodialysis. Arthritis Rheum., 1985, 28, 1052–1058.
Brown, E.A., Arnold, I.R., Gower, P.E. Dialysis arthropathy: complication of long-term treatment with haemodialysis. Br Med J, 1986, 292, 163–166.
Chanard, J., Lavaud, S., Toupanle, O., Melin, J.P., Gillery, P., Revillard, J.P. β2 microglobulinassociated amyloidosis in chronic haemodialysis patients. Lancet, 1986, 1, 1212.
Eknoyan, G. Side effects of hemodialysis. N Engl J Med, 1984, 311, 915–917.
Foissac-Gegoux, Ph., Hardouin, P., Flipo, R.M., Dumont, A., Delcambre, B. Vers une prévention de l'amylose des hémodialysés: étude des capacités d'épuration de la \2-microglobuline par différentes membranes. Presse Med, 1987, 16, 490.
Gejyo, F., Yamada, T., Odani, S., Nakagawa, Y., Arakawa, M., Kunitomo, T., Kataoka, M., Suzuki, M., Hirasawa, Y., Shirahama, T., Cohen, A.S., Schmid, K. A new form of amyloid protein associated with chronic hemodialysis was identified as β2-microglobulin. Biochem Biophys Res Commun, 1985, 129, 701–706.
Gejyo, F., Homma, N., Suzuki, Y., Arakawa, M. Serum levels of β2-microglobulin as a new form of amyloid protein in patients undergoing long-term hemodialysis. N Engl J Med, 1986, 314, 585–586.
Goldstein, S., Winston, E., Jin Chung, T., Chopra, S., Pariser, K. Chronic arthropathy in longterm hemodialysis. Am J Med, 1985, 78, 82–86.
Gorevic, P.D., Casey, T.T., Stone, W.J., Diraimondo, C.R., Prelli, F.C., Frangione, B. β2-microglobulin is an amyloidogenic protein in man. J Clin Invest, 1985, 76, 2423–2429.
Hakim, R.M., Breillatt, J., Lazarus, J.M., Port, F.K. Complement activation and hypersensitivity reactions to dialysis membranes. N Engl J Med, 1984, 311, 878–882.
Hardouin, P., Flipo, R.M., Foissac-Gegoux, Ph., Lecomte-Houcke, M., Duquesnoy, B., Delcambre, B. Aspects actuels de la pathologie ostéo-articulaire des hémodialysés. Etude d'une population de 80 patients. Rev Rhum, 1987, 54, 469–473.
Hauglustaine, D., Waer, M., Michielsen, P., Goebels, J., Vandeputte, M. Haemodialysis membranes, serum β2-microglobulin and dialysis amyloidosis. Lancet, 1986, 1, 1211.
Huaux, J.P., Noel, H., Bastien, P., Malghem, J., Maldague, B., Devogelaer, J.P., Nagant de Deuxchaisnes, C. Amylose articulaire, fracture du col fémoral et hémodialyse périodique chronique. Rev Rhum, 1985, 52, 179–182.
Kessler, M. Bio-incompatibilité à long terme en hémodialyse. Néphrologie, 1985, 6, 231–234.
Laurent, G., Charra, B., Calemard, E., Uzan, M., Vanel, T., Terrat, J.C. Amélioration par la dialyse péritonéale continue ambulatoire des douleurs abarticulaires accompagnant le syndrome du canal carpien des hémodialysés. Presse Méd, 1985, 14, 2105–2106.
Munoz-Gomez, J., Bergada-Barado, E., Gomez-Perez, R., Llopart-Buisan, E., Subias-Sorevia, E., Rotes-Querol, J., Sole-Arques, M. Amyloid arthropathy in patients undergoing periodical haemodialysis for chronic renal failure: a new complication. Ann Rheum Dis, 1985, 44, 729–733.
Sebert, J.L., Fardellone, P., Marie, A., Lambrey, G., Deramond, H., Legars, D., Galibert, P., Smajda, A., Fournier, A. Destructive spondylarthropathy in hemodialyzed patients: possible role of amyloidosis. Arthritis Rheum, 1986, 29, 301–303.
Vandenbroucke, J.M., Huaux, J.P., Nagant de Deuxchaisnes, C., Van Ypersele en Strihou, C. Dialysis arthropathy: complication of long-term treatment with hemodialysis. Br Med J, 1986, 292, 556.
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Hardouin, P., Flipo, R.M., Foissac-Gegoux, P. et al. Dialysis — relatedβ2 microglobulin — Amyloid arthropathy Improvement of clinical symptoms after a switch of dialysis membranes. Clin Rheumatol 7, 41–45 (1988). https://doi.org/10.1007/BF02284055
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DOI: https://doi.org/10.1007/BF02284055