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Epidemiological survey and risk factor analysis of dialysis-related amyloidosis including destructive spondyloarthropathy, dialysis amyloid arthropathy, and carpal tunnel syndrome

  • Atsushi Tagami
  • Masato TomitaEmail author
  • Shinji Adachi
  • Keiichi Tsuda
  • Shuta Yamada
  • Koh Chiba
  • Narihiro Okazaki
  • Akihiko Yonekura
  • Ritsu Tsujimoto
  • Shiro Kajiyama
  • Shohei Matsubayashi
  • Takashi Miyamoto
  • Yasushi Mochizuki
  • Kojiro Ohba
  • Makoto Osaki
Original Article

Abstract

The RDT population, initially at 215 patients, exceeded 300,000 in 2011, with a total of 329,609 patients at the end of December 2016. In our Institute, the number of patients with destructive spondylosis is increasing with the increase in the number of dialysis patients in Japan. We had 14 Cases in the 1990s, and then 82 cases in the 2000s and have already had 131 cases in the 2010s. The purpose of this study was to investigate the incidence of dialysis-related amyloidosis (DRA) such as destructive spondyloarthropathy (DSA), dialysis amyloid arthropathy (DAA), and carpal tunnel syndrome (CTS). In addition, another purpose was to examine the risk factors of the DRA. DAA made its own assessment on radiographs based on stage. Survey items were patient’s basic data, laboratory data and X-ray view. Patientʼs basic data included such as sex, age, height, and weight and RDT-related factors such as kidney disease that led to RDT, age at start of RDT, RDT history, medical history (past and present), and history of surgery. The frequency of DRA was examined by medical history and radiological examination in 199 dialysis patients who obtained informed consent. The patients were divided into two groups according to the presence or absence of DRA, and risk factors of DRA were investigated from the medical history, basic data of patients, and blood tests. Of the 199 patients on regular dialysis therapy, 41 (20.6%) showed DRA. Based on the X-ray images, 21 patients (10.6%) showed DSA, while 22 patients (11.1%) showed DAA. Sixteen patients (8.0%) had CTS, determined through a history of surgery. Regarding overlap of conditions, 14 had both DSA and DAA, 3 had both DSA and CTS, and 2 had both DAA and CTS. There were statistically significant differences between the two groups in the cause of disease in Chronic glomerulonephritis and Diabetic Nephropathy, age at the start of RDT, period of RDT, body weight, blood platelet count, and blood Ca level. When multivariate analysis was performed on these items, statistical differences were recognized only during the dialysis period. In conclusion, long dialysis period was a risk factor for DRA.

Keywords

Regular dialysis therapy Dialysis-related amyloidosis Destructive spondyloarthropathy Dialysis amyloid arthropathy Carpal tunnel syndrome 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

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Copyright information

© The Japanese Society Bone and Mineral Research and Springer Japan KK, part of Springer Nature 2019

Authors and Affiliations

  • Atsushi Tagami
    • 1
  • Masato Tomita
    • 1
    Email author
  • Shinji Adachi
    • 1
  • Keiichi Tsuda
    • 1
  • Shuta Yamada
    • 1
  • Koh Chiba
    • 1
  • Narihiro Okazaki
    • 1
  • Akihiko Yonekura
    • 1
  • Ritsu Tsujimoto
    • 1
  • Shiro Kajiyama
    • 1
  • Shohei Matsubayashi
    • 1
  • Takashi Miyamoto
    • 1
  • Yasushi Mochizuki
    • 2
  • Kojiro Ohba
    • 2
  • Makoto Osaki
    • 1
  1. 1.Department of Orthopaedic SurgeryNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
  2. 2.Department of UrologyNagasaki University Graduate School of Biomedical SciencesNagasakiJapan

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