Document Detail


Dialysis-related amyloidosis of the heart in long-term hemodialysis patients.
MedLine Citation:
PMID:  11169005     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Dialysis-related amyloidosis (DRA) predominantly occurs in the osteoarticular structures, but it also systemically appears in the extra-articular tissues as well. However, the pathological characteristics of DRA in the hearts of hemodialysis (HD) patients have rarely been reported. METHODS: We studied the pathological characteristics of DRA in the hearts of 18 HD patients, including its relationship to calcification. Furthermore, we studied the immunohistochemical localization of advanced glycation end products (AGEs) using monoclonal anti-imidazolone and anti-Nepsilon-(carboxymethyl)lysine (CML) antibodies. RESULTS: beta2-microglobulin (beta2m) amyloid deposits were detected in the hearts of seven patients who had undergone HD for more than 10 years. beta2m amyloid deposits in the left atrium were localized in the endocardium, the myocardium, and the walls of small blood vessels, whereas in the left ventricle, they were localized only in the walls of small blood vessels. The extent and prevalence of DRA in the heart were severe in the patients on HD for more than 15 years. Most calcification areas near mitral valve were dotted with beta2m amyloid deposits, while diffuse fine calcification was localized within the beta2m amyloid tissues in some cases. Imidazolone and CML were localized not only in massive beta2m amyloid deposits, but also in cardiac myocytes. CONCLUSION: DRAs were localized extensively in the hearts of long-term HD patients. A strong affinity was observed between beta2m amyloid deposits and calcification.
Authors:
F Takayama; S Miyazaki; T Morita; Y Hirasawa; T Niwa
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Kidney international. Supplement     Volume:  78     ISSN:  0098-6577     ISO Abbreviation:  Kidney Int. Suppl.     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2001-02-22     Completed Date:  2001-04-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7508622     Medline TA:  Kidney Int Suppl     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S172-6     Citation Subset:  IM    
Affiliation:
Nagoya University Daiko Medical Center, Nagoya, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Amyloidosis / etiology*,  metabolism,  pathology
Calcinosis / etiology
Cardiomyopathies / etiology*,  metabolism,  pathology
Female
Humans
Male
Middle Aged
Renal Dialysis / adverse effects*
Time Factors
beta 2-Microglobulin / metabolism
Chemical
Reg. No./Substance:
0/beta 2-Microglobulin

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