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- Title
Long term effect of renal transplantation on dialysis-related amyloid deposits and symptomatology.
- Authors
Tan, Si-Yen; Irish, Ashley; Winearls, Christopher G.; Brown, Edwina A.; Gower, Peter E.; Clutterbuck, Elaine J.; Madhoo, Sheril; Lavender, J. Peter; Pepys, Mark B.; Hawkins, Philip N.
- Abstract
We report the five year outcome of nine patients with dialysis-related amyloid (DRA) who underwent successful renal transplantation (RT) and six patients who remained on hemodialysis (HD). Amyloid bone cysts, a radiologic feature of DRA, and scintigraphy with 123I-1abeled serum amyloid P component (SAP), a specific technique for evaluating amyloid deposits in vivo, were monitored and compared with clinical features. In all HD patients there was clinical, scintigraphic and/or radiologic evidence that DRA progressed. In contrast, eight of the RT patients experienced profound early relief of DRA symptoms following transplantation that persisted throughout follow-up, despite the reduction or withdrawal of corticosteroids. Amyloid bone cysts improved in four patients and SAP scans demonstrated regression of articular amyloid in eight out of nine cases. The modest radiographic improvement suggests that amyloid is mobilized more slowly in bone cysts than elsewhere or that cystic bone is remodeled poorly. This is the first objective evidence that DKA regresses following renal transplantation, and suggests that this may contribute to the long-term relief of DRA symptoms in transplant recipients who discontinue corticosteroids.
- Subjects
HEMODIALYSIS; HEMODIALYSIS patients; KIDNEY transplantation; AMYLOID; DIALYSIS (Chemistry); ENDOCRINE manifestations of general diseases; TRANSPLANTATION of organs, tissues, etc.
- Publication
Kidney International, 1996, Vol 50, Issue 1, p282
- ISSN
0085-2538
- Publication type
Article
- DOI
10.1038/ki.1996.313