Joint and systemic distribution of dialysis amyloid.
Athanasou NA., Ayers D., Rainey AJ., Oliver DO., Duthie RB.
Deposition of beta 2-microglobulin amyloid in the joints of dialysis patients is common and begins early in the course of treatment, but its pathogenic significance in the production of dialysis arthropathy is uncertain. The joints (hip, knee, shoulder, elbow, wrist, cervical and lumbar spine, sacroiliac joint) and systemic tissues of 19 autopsied patients who had undergone haemodialysis for between 6 and 231 months were examined histopathologically for the presence of beta 2-microglobulin amyloid; it was present in all joints examined, including those unassociated with radiological changes and those of patients who had been on haemodialysis alone for only 24 months. Osteoarticular beta 2-microglobulin amyloid deposits were also found in patients who had been treated mainly by continuous ambulatory peritoneal dialysis. Systemic amyloid deposition was only seen in patients who had been haemodialysed for more than 13 years and consisted of sparse tiny deposits in blood vessel walls.