Dialysis is often required for patients with kidney failure. The purpose of dialysis is to compensate for the loss of renal function. Dialysis is not perfect, however, and long-term dialysis treatment can lead to the development of a systemic condition known as amyloidosis, which is caused by the deposition of proteins onto various tissues.
Amyloidosis
Amyloidosis, according to the National Institute of Diabetes and Digestive and Kidney Diseases, is a result of abnormally shaped proteins accumulating in the body. Proteins throughout the body have a distinct shape which helps control their function. If proteins become folded improperly, however, they can adopt an irregular shape and form large clumps of protein called amyloid. These amyloid fibers can become deposited throughout the body and cause tissue damage and inflammation.
Dialysis and Microglobulin
One hazard of long-term dialysis treatment is the development of dialysis-related amyloidosis, which is the result of accumulation of a protein called beta-2 microglobulin. Beta-2 microglobulin, according to a 2006 article in "Seminars in Dialysis," is a protein which is found on many different cells throughout the body and which circulates in the blood. Normally this protein is filtered from the blood by the kidneys and excreted in the urine. Patients on dialysis do not have functioning kidneys, and the dialysis machinery is unable to remove this protein.
Microglobulin Amyloid Formation
Because dialysis treatment does not remove beta-2 microglobulin from the blood, it accumulates in the body, the "Seminars in Dialysis" article explains. When the protein builds up to high concentrations in the blood, it can form the amyloid aggregates. The article notes that twenty percent of all patients who have received dialysis for two years have measurable amounts of amyloid formed from beta-2 microglobulin in their system.
Amyloidosis Symptoms
Dialysis-related amyloidosis primarily causes amyloid deposition in the joints, Cure Research explains. This can lead to join stiffness and pain as a result of inflammation triggered by the amyloid clumps. Amyloid can also be placed on the ligaments and tendons, which can make them tear more easily. Common complications of dialysis-related amyloidosis include bone cysts and carpal tunnel syndrome. Bone cysts can weaken the bones.
Treatment
Dialysis-related amyloidosis cannot be cured, Cure Research explains. The progression of the disease can be slowed, however, by the use of high-flux dialysis machines, which filter the blood more quickly. Some of the complications of amyloidosis, such as bone cysts and carpal tunnel syndrome, can be treated surgically to relieve pain and bone weakness. A kidney transplant can be done, however, to make dialysis unnecessary, which will stop the disease's progression.
