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Dialysis-related amyloidosis

Jonathan Kay, MD
William L Henrich, MD, MACP
Wajeh Y Qunibi, MD
Section Editors
Jeffrey S Berns, MD
Steve J Schwab, MD
Deputy Editor
Alice M Sheridan, MD


Dialysis-related amyloidosis (DRA) is a disabling disease characterized by accumulation and tissue deposition of amyloid fibrils consisting of beta2-microglobulin (beta2-m) in the bone, periarticular structures, and viscera of patients with chronic kidney disease (CKD) [1-8]. Beta2-m is a component of the major histocompatibility complex that is present on cell surfaces and is normally cleared by glomerular filtration, with subsequent reabsorption and catabolism in proximal tubules. Clearance declines in patients with reduced kidney function, which leads to plasma accumulation and slow tissue deposition.

The prevalence of DRA has decreased with the use of high-flux biocompatible membranes, which provide better clearance of beta2-m and are less likely to induce reactive inflammation. (See 'Epidemiology and risk factors' below.)

However, even these more modern hemodialysis therapies can be associated with retention of beta2-m. An overview of DRA is presented in this topic review. Other bone diseases and other complications associated with renal disease are discussed elsewhere. (See "Overview of chronic kidney disease-mineral and bone disorder (CKD-MBD)" and "Management of secondary hyperparathyroidism in adult nondialysis patients with chronic kidney disease" and "Management of secondary hyperparathyroidism in dialysis patients" and "Complications of hemodialysis in the older patient".)

Other forms of amyloidosis are also discussed elsewhere. (See "Overview of amyloidosis".)


DRA is characterized by the tissue deposition of beta2-microglobulin (beta2-m) amyloid, particularly in bone, articular cartilage, synovium, muscle, tendons, and ligaments [9-11]. Beta2-m amyloid also deposits in other tissues, especially blood vessels [10,12] and the gastrointestinal tract [12]. In contrast to fragments of immunoglobulin light chains in primary amyloidosis and serum amyloid A in secondary amyloidosis, the amyloid protein in DRA is composed primarily of beta2-m [2,13,14].

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Literature review current through: Nov 2017. | This topic last updated: Jul 01, 2016.
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  1. Fenves AZ, Emmett M, White MG, et al. Carpal tunnel syndrome with cystic bone lesions secondary to amyloidosis in chronic hemodialysis patients. Am J Kidney Dis 1986; 7:130.
  2. Koch KM. Dialysis-related amyloidosis. Kidney Int 1992; 41:1416.
  3. Gejyo F, Odani S, Yamada T, et al. Beta 2-microglobulin: a new form of amyloid protein associated with chronic hemodialysis. Kidney Int 1986; 30:385.
  4. Miyata T, Jadoul M, Kurokawa K, Van Ypersele de Strihou C. Beta-2 microglobulin in renal disease. J Am Soc Nephrol 1998; 9:1723.
  5. National Kidney Foundation. K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease. Am J Kidney Dis 2003; 42:S1.
  6. Winchester JF, Salsberg JA, Levin NW. Beta-2 microglobulin in ESRD: an in-depth review. Adv Ren Replace Ther 2003; 10:279.
  7. Dember LM, Jaber BL. Dialysis-related amyloidosis: late finding or hidden epidemic? Semin Dial 2006; 19:105.
  8. Morrow B, Qunibi W. Specific bone and mineral disorders in patients with chronic kidney disease. Clinic Rev Bone Miner Metab 2012; 10:184.
  9. Athanasou NA, Ayers D, Rainey AJ, et al. Joint and systemic distribution of dialysis amyloid. Q J Med 1991; 78:205.
  10. Noël LH, Zingraff J, Bardin T, et al. Tissue distribution of dialysis amyloidosis. Clin Nephrol 1987; 27:175.
  11. Nakazawa R, Hamaguchi K, Hosaka E, et al. Synovial amyloidosis of beta 2-microglobulin type in patients undergoing long-term hemodialysis. Nephron 1986; 44:379.
  12. Jimenez RE, Price DA, Pinkus GS, et al. Development of gastrointestinal beta2-microglobulin amyloidosis correlates with time on dialysis. Am J Surg Pathol 1998; 22:729.
  13. Gorevic PD, Munoz PC, Casey TT, et al. Polymerization of intact beta 2-microglobulin in tissue causes amyloidosis in patients on chronic hemodialysis. Proc Natl Acad Sci U S A 1986; 83:7908.
  14. van Ypersele De Strihou C, Jadoul M, Garbar C. Morphogenesis of joint beta 2-microglobulin amyloid deposits. Nephrol Dial Transplant 2001; 16 Suppl 4:3.
  15. Evenepoel P, Bammens B, Verbeke K, Vanrenterghem Y. Superior dialytic clearance of beta(2)-microglobulin and p-cresol by high-flux hemodialysis as compared to peritoneal dialysis. Kidney Int 2006; 70:794.
  16. Floege J, Koch KM. Beta 2-microglobulin associated amyloidosis and therapy with high flux hemodialysis membranes. Clin Nephrol 1994; 42 Suppl 1:S52.
  17. Schoels M, Jahn B, Hug F, et al. Stimulation of mononuclear cells by contact with cuprophan membranes: further increase of beta 2-microglobulin synthesis by activated late complement components. Am J Kidney Dis 1993; 21:394.
  18. Zaoui PM, Stone WJ, Hakim RM. Effects of dialysis membranes on beta 2-microglobulin production and cellular expression. Kidney Int 1990; 38:962.
  19. Matsuo K, Ikizler TA, Hoover RL, et al. Transforming growth factor-beta is involved in the pathogenesis of dialysis-related amyloidosis. Kidney Int 2000; 57:697.
  20. García-García M, Argilés, Gouin-Charnet A, et al. Impaired lysosomal processing of beta2-microglobulin by infiltrating macrophages in dialysis amyloidosis. Kidney Int 1999; 55:899.
  21. Drüeke TB, Massy ZA. Beta2-microglobulin. Semin Dial 2009; 22:378.
  22. Morinière P, Marie A, el Esper N, et al. Destructive spondyloarthropathy with beta 2-microglobulin amyloid deposits in a uremic patient before chronic hemodialysis. Nephron 1991; 59:654.
  23. Gejyo F, Homma N, Suzuki Y, Arakawa M. Serum levels of beta 2-microglobulin as a new form of amyloid protein in patients undergoing long-term hemodialysis. N Engl J Med 1986; 314:585.
  24. Yamamoto S, Kazama JJ, Narita I, et al. Recent progress in understanding dialysis-related amyloidosis. Bone 2009; 45 Suppl 1:S39.
  25. Ookoshi T, Hasegawa K, Ohhashi Y, et al. Lysophospholipids induce the nucleation and extension of beta2-microglobulin-related amyloid fibrils at a neutral pH. Nephrol Dial Transplant 2008; 23:3247.
  26. Niwa T, Katsuzaki T, Momoi T, et al. Modification of beta 2m with advanced glycation end products as observed in dialysis-related amyloidosis by 3-DG accumulating in uremic serum. Kidney Int 1996; 49:861.
  27. Niwa T. 3-Deoxyglucosone: metabolism, analysis, biological activity, and clinical implication. J Chromatogr B Biomed Sci Appl 1999; 731:23.
  28. Miyata T, Inagi R, Iida Y, et al. Involvement of beta 2-microglobulin modified with advanced glycation end products in the pathogenesis of hemodialysis-associated amyloidosis. Induction of human monocyte chemotaxis and macrophage secretion of tumor necrosis factor-alpha and interleukin-1. J Clin Invest 1994; 93:521.
  29. Hou FF, Miyata T, Boyce J, et al. beta(2)-Microglobulin modified with advanced glycation end products delays monocyte apoptosis. Kidney Int 2001; 59:990.
  30. Hou FF, Jiang JP, Guo JQ, et al. Receptor for advanced glycation end products on human synovial fibroblasts: role in the pathogenesis of dialysis-related amyloidosis. J Am Soc Nephrol 2002; 13:1296.
  31. Hou FF, Boyce J, Chertow GM, et al. Aminoguanidine inhibits advanced glycation end products formation on beta2-microglobulin. J Am Soc Nephrol 1998; 9:277.
  32. Menaa C, Esser E, Sprague SM. Beta2-microglobulin stimulates osteoclast formation. Kidney Int 2008; 73:1275.
  33. Kay J. B2-microglobulin amyloidosis. Amyloid Int J Exp Clin Invest 1997; 4:187.
  34. Jadoul M, Garbar C, Noël H, et al. Histological prevalence of beta 2-microglobulin amyloidosis in hemodialysis: a prospective post-mortem study. Kidney Int 1997; 51:1928.
  35. Hoshino J, Yamagata K, Nishi S, et al. Significance of the decreased risk of dialysis-related amyloidosis now proven by results from Japanese nationwide surveys in 1998 and 2010. Nephrol Dial Transplant 2016; 31:595.
  36. Cianciolo G, Colí L, La Manna G, et al. Is beta2-microglobulin-related amyloidosis of hemodialysis patients a multifactorial disease? A new pathogenetic approach. Int J Artif Organs 2007; 30:864.
  37. Fry AC, Singh DK, Chandna SM, Farrington K. Relative importance of residual renal function and convection in determining beta-2-microglobulin levels in high-flux haemodialysis and on-line haemodiafiltration. Blood Purif 2007; 25:295.
  38. Schiffl H. Impact of advanced dialysis technology on the prevalence of dialysis-related amyloidosis in long-term maintenance dialysis patients. Hemodial Int 2014; 18:136.
  39. van Ypersele de Strihou C, Jadoul M, Malghem J, et al. Effect of dialysis membrane and patient's age on signs of dialysis-related amyloidosis. The Working Party on Dialysis Amyloidosis. Kidney Int 1991; 39:1012.
  40. Schiffl H, Fischer R, Lang SM, Mangel E. Clinical manifestations of AB-amyloidosis: effects of biocompatibility and flux. Nephrol Dial Transplant 2000; 15:840.
  41. Traut M, Haufe CC, Eismann U, et al. Increased binding of beta-2-microglobulin to blood cells in dialysis patients treated with high-flux dialyzers compared with low-flux membranes contributed to reduced beta-2-microglobulin concentrations. Results of a cross-over study. Blood Purif 2007; 25:432.
  42. Zingraff J, Beyne P, Ureña P, et al. Influence of haemodialysis membranes on beta 2-microglobulin kinetics: in vivo and in vitro studies. Nephrol Dial Transplant 1988; 3:284.
  43. Kaiser JP, Hagemann J, von Herrath D, Schaefer K. Different handling of beta 2-microglobulin during hemodialysis and hemofiltration. Nephron 1988; 48:132.
  44. Ullian ME, Hammond WS, Alfrey AC, et al. Beta-2-microglobulin-associated amyloidosis in chronic hemodialysis patients with carpal tunnel syndrome. Medicine (Baltimore) 1989; 68:107.
  45. Goldman M, Lagmiche M, Dhaene M, et al. Adsorption of beta 2-microglobulin on dialysis membranes: comparison of different dialyzers and effects of reuse procedures. Int J Artif Organs 1989; 12:373.
  46. Gejyo F, Narita I. Current clinical and pathogenetic understanding of beta2-m amyloidosis in long-term haemodialysis patients. Nephrology (Carlton) 2003; 8 Suppl:S45.
  47. Eknoyan G, Beck GJ, Cheung AK, et al. Effect of dialysis dose and membrane flux in maintenance hemodialysis. N Engl J Med 2002; 347:2010.
  48. Hartmann J, Fricke H, Schiffl H. Biocompatible membranes preserve residual renal function in patients undergoing regular hemodialysis. Am J Kidney Dis 1997; 30:366.
  49. Schiffl H, Lang SM, Fischer R. Ultrapure dialysis fluid slows loss of residual renal function in new dialysis patients. Nephrol Dial Transplant 2002; 17:1814.
  50. Hakim RM, Wingard RL, Husni L, et al. The effect of membrane biocompatibility on plasma beta 2-microglobulin levels in chronic hemodialysis patients. J Am Soc Nephrol 1996; 7:472.
  51. Kessler M, Netter P, Azoulay E, et al. Dialysis-associated arthropathy: a multicentre survey of 171 patients receiving haemodialysis for over 10 years. The Co-operative Group on Dialysis-associated Arthropathy. Br J Rheumatol 1992; 31:157.
  52. Brunner FP, Brynger H, Ehrich JH, et al. Case control study on dialysis arthropathy: the influence of two different dialysis membranes: data from the EDTA Registry. Nephrol Dial Transplant 1990; 5:432.
  53. McCarthy JT, Williams AW, Johnson WJ. Serum beta 2-microglobulin concentration in dialysis patients: importance of intrinsic renal function. J Lab Clin Med 1994; 123:495.
  54. Sprague SM, Moe SM. Clinical manifestations and pathogenesis of dialysis-related amyloidosis. Semin Dial 1996; 9:360.
  55. Laurent G, Calemard E, Charra B. Dialysis related amyloidosis. Kidney Int Suppl 1988; 24:S32.
  56. Gilbert MS, Robinson A, Baez A, et al. Carpal tunnel syndrome in patients who are receiving long-term renal hemodialysis. J Bone Joint Surg Am 1988; 70:1145.
  57. Kenzora JE. Dialysis carpal tunnel syndrome. Orthopedics 1978; 1:195.
  58. Orzincolo C, Bedani PL, Scutellari PN, et al. Destructive spondyloarthropathy and radiographic follow-up in hemodialysis patients. Skeletal Radiol 1990; 19:483.
  59. Maruyama H, Gejyo F, Arakawa M. Clinical studies of destructive spondyloarthropathy in long-term hemodialysis patients. Nephron 1992; 61:37.
  60. Allard JC, Artze ME, Porter G, et al. Fatal destructive cervical spondyloarthropathy in two patients on long-term dialysis. Am J Kidney Dis 1992; 19:81.
  61. Marcelli C, Pérennou D, Cyteval C, et al. Amyloidosis-related cauda equina compression in long-term hemodialysis patients. Three case reports. Spine (Phila Pa 1976) 1996; 21:381.
  62. Allain TJ, Stevens PE, Bridges LR, Phillips ME. Dialysis myelopathy: quadriparesis due to extradural amyloid of beta 2 microglobulin origin. Br Med J (Clin Res Ed) 1988; 296:752.
  63. Sanchez R, Praga M, Rivas Salas JJ, et al. Compressive myelopathy due to dialysis-associated amyloidosis. Nephron 1993; 65:463.
  64. Campistol JM, Solé M, Muñoz-Gómez J, et al. Pathological fractures in patients who have amyloidosis associated with dialysis. A report of five cases. J Bone Joint Surg Am 1990; 72:568.
  65. Ikegaya N, Kobayashi S, Hishida A, et al. Colonic dilatation due to dialysis-related amyloidosis. Am J Kidney Dis 1995; 25:807.
  66. Takahashi S, Morita T, Koda Y, et al. Gastrointestinal involvement of dialysis-related amyloidosis. Clin Nephrol 1988; 30:168.
  67. Dulgheru EC, Balos LL, Baer AN. Gastrointestinal complications of beta2-microglobulin amyloidosis: a case report and review of the literature. Arthritis Rheum 2005; 53:142.
  68. Sethi D, Hutchison AJ, Cary NR, et al. Macroglossia and amyloidoma of the buttock: evidence of systemic involvement in dialysis amyloid. Nephron 1990; 55:312.
  69. Guccion JG, Redman RS, Winne CE. Hemodialysis-associated amyloidosis presenting as lingual nodules. Oral Surg Oral Med Oral Pathol 1989; 68:618.
  70. Zhou H, Pfeifer U, Linke R. Generalized amyloidosis from beta 2-microglobulin, with caecal perforation after long-term haemodialysis. Virchows Arch A Pathol Anat Histopathol 1991; 419:349.
  71. Shinoda T, Komatsu M, Aizawa T, et al. Intestinal pseudo-obstruction due to dialysis amyloidosis. Clin Nephrol 1989; 32:284.
  72. Gal R, Korzets A, Schwartz A, et al. Systemic distribution of beta 2-microglobulin-derived amyloidosis in patients who undergo long-term hemodialysis. Report of seven cases and review of the literature. Arch Pathol Lab Med 1994; 118:718.
  73. Choi HS, Heller D, Picken MM, et al. Infarction of intestine with massive amyloid deposition in two patients on long-term hemodialysis. Gastroenterology 1989; 96:230.
  74. Picken MM, Shen S. beta 2-Microglobulin amyloidosis: illustrative cases. Ultrastruct Pathol 1994; 18:133.
  75. Wu TH, Tsai CY, Chiang SS, et al. Dialysis-related amyloidosis and acquired renal cystic disease with renal cell carcinoma in uremia. Nephron 1994; 67:129.
  76. Borczuk A, Mannion C, Dickson D, Alt E. Intestinal pseudo-obstruction and ischemia secondary to both beta 2-microglobulin and serum A amyloid deposition. Mod Pathol 1995; 8:577.
  77. Floege J, Brandis A, Nonnast-Daniel B, et al. Subcutaneous amyloid-tumor of beta-2-microglobulin origin in a long-term hemodialysis patient. Nephron 1989; 53:73.
  78. Kay J, Benson CB, Lester S, et al. Utility of high-resolution ultrasound for the diagnosis of dialysis-related amyloidosis. Arthritis Rheum 1992; 35:926.
  79. Chattopadhyay C, Ackrill P, Clague RB. The shoulder pain syndrome and soft-tissue abnormalities in patients on long-term haemodialysis. Br J Rheumatol 1987; 26:181.
  80. Gravallese EM, Baker N, Lester S, et al. Musculoskeletal manifestations in beta 2-microglobulin amyloidosis. Case discussion. Arthritis Rheum 1992; 35:592.
  81. Maury CP. beta 2-Microglobulin amyloidosis. A systemic amyloid disease affecting primarily synovium and bone in long-term dialysis patients. Rheumatol Int 1990; 10:1.
  82. Cheung AK, Rocco MV, Yan G, et al. Serum beta-2 microglobulin levels predict mortality in dialysis patients: results of the HEMO study. J Am Soc Nephrol 2006; 17:546.
  83. Kazama JJ, Yamamoto S, Takahashi N, et al. Abeta-2M-amyloidosis and related bone diseases. J Bone Miner Metab 2006; 24:182.
  84. Stone WJ. Beta2-microglobulin-associated amyloidosis of end-stage renal disease. In: Principles and Practice of Dialysis, 3rd ed, Henrich WL (Ed), Lippincott, Williams & Wilkins, Philadelphia 2005.
  85. Kiss E, Keusch G, Zanetti M, et al. Dialysis-related amyloidosis revisited. AJR Am J Roentgenol 2005; 185:1460.
  86. Slavotinek JP, Coates PT, McDonald SP, et al. Shoulder appearances at MR imaging in long-term dialysis recipients. Radiology 2000; 217:539.
  87. Cardinal E, Buckwalter KA, Braunstein EM, et al. Amyloidosis of the shoulder in patients on chronic hemodialysis: sonographic findings. AJR Am J Roentgenol 1996; 166:153.
  88. Sommer R, Valen GJ, Ori Y, et al. Sonographic features of dialysis-related amyloidosis of the shoulder. J Ultrasound Med 2000; 19:765.
  89. Jadoul M, Malghem J, Vande Berg B, van Ypersele de Strihou C. Ultrasonographic detection of thickened joint capsules and tendons as marker of dialysis-related amyloidosis: a cross-sectional and longitudinal study. Nephrol Dial Transplant 1993; 8:1104.
  90. Floege J, Schäffer J, Ehlerding G. Beta 2-microglobulin-derived amyloidosis: clinical use of scintigraphy and insights into its pathogenesis. Nephrol Dial Transplant 1993; 8:792.
  91. Tan SY, Baillod R, Brown E, et al. Clinical, radiological and serum amyloid P component scintigraphic features of beta2-microglobulin amyloidosis associated with continuous ambulatory peritoneal dialysis. Nephrol Dial Transplant 1999; 14:1467.
  92. Schäffer J, Burchert W, Floege J, et al. Recombinant versus natural human 111In-beta2-microglobulin for scintigraphic detection of Abeta2m amyloid in dialysis patients. Kidney Int 2000; 58:873.
  93. Nelson SR, Hawkins PN, Richardson S, et al. Imaging of haemodialysis-associated amyloidosis with 123I-serum amyloid P component. Lancet 1991; 338:335.
  94. Campistol JM. Dialysis-related amyloidosis after renal transplantation. Semin Dial 2001; 14:99.
  95. Tan SY, Pepys MB, Hawkins PN. Treatment of amyloidosis. Am J Kidney Dis 1995; 26:267.
  96. Mourad G, Argilés A. Renal transplantation relieves the symptoms but does not reverse beta 2-microglobulin amyloidosis. J Am Soc Nephrol 1996; 7:798.
  97. Tan SY, Irish A, Winearls CG, et al. Long term effect of renal transplantation on dialysis-related amyloid deposits and symptomatology. Kidney Int 1996; 50:282.
  98. Jadoul M, Malghem J, Pirson Y, et al. Effect of renal transplantation on the radiological signs of dialysis amyloid osteoarthropathy. Clin Nephrol 1989; 32:194.
  99. Diaz RJ, Washburn S, Cauble L, et al. The effect of dialyzer reprocessing on performance and beta 2-microglobulin removal using polysulfone membranes. Am J Kidney Dis 1993; 21:405.
  100. Pellicano R, Polkinghorne KR, Kerr PG. Reduction in beta2-microglobulin with super-flux versus high-flux dialysis membranes: results of a 6-week, randomized, double-blind, crossover trial. Am J Kidney Dis 2008; 52:93.
  101. Leypoldt JK. Kinetics of beta2-microglobulin and phosphate during hemodialysis: effects of treatment frequency and duration. Semin Dial 2005; 18:401.
  102. Raj DS, Ouwendyk M, Francoeur R, Pierratos A. beta(2)-microglobulin kinetics in nocturnal haemodialysis. Nephrol Dial Transplant 2000; 15:58.
  103. van Ypersele de Strihou C, Honhon B, Vandenbroucke JM, et al. Dialysis amyloidosis. Adv Nephrol Necker Hosp 1988; 17:401.
  104. Lornoy W, Becaus I, Billiouw JM, et al. On-line haemodiafiltration. Remarkable removal of beta2-microglobulin. Long-term clinical observations. Nephrol Dial Transplant 2000; 15 Suppl 1:49.
  105. Yavuz A, Tetta C, Ersoy FF, et al. Uremic toxins: a new focus on an old subject. Semin Dial 2005; 18:203.
  106. Canaud B, Assounga A, Kerr P, et al. Failure of a daily haemofiltration programme using a highly permeable membrane to return beta 2-microglobulin concentrations to normal in haemodialysis patients. Nephrol Dial Transplant 1992; 7:924.
  107. Penne EL, van der Weerd NC, Blankestijn PJ, et al. Role of residual kidney function and convective volume on change in beta2-microglobulin levels in hemodiafiltration patients. Clin J Am Soc Nephrol 2010; 5:80.
  108. Locatelli F, Marcelli D, Conte F, et al. Comparison of mortality in ESRD patients on convective and diffusive extracorporeal treatments. The Registro Lombardo Dialisi E Trapianto. Kidney Int 1999; 55:286.
  109. Koda Y, Nishi S, Miyazaki S, et al. Switch from conventional to high-flux membrane reduces the risk of carpal tunnel syndrome and mortality of hemodialysis patients. Kidney Int 1997; 52:1096.
  110. Nakai S, Iseki K, Tabei K, et al. Outcomes of hemodiafiltration based on Japanese dialysis patient registry. Am J Kidney Dis 2001; 38:S212.
  111. Rabindranath KS, Strippoli GF, Roderick P, et al. Comparison of hemodialysis, hemofiltration, and acetate-free biofiltration for ESRD: systematic review. Am J Kidney Dis 2005; 45:437.
  112. Jadoul M, Noel H, van Ypersele de Strihou C. Beta 2-microglobulin amyloidosis in a patient treated exclusively by continuous ambulatory peritoneal dialysis. Am J Kidney Dis 1990; 15:86.
  113. Benz RL, Siegfried JW, Teehan BP. Carpal tunnel syndrome in dialysis patients: comparison between continuous ambulatory peritoneal dialysis and hemodialysis populations. Am J Kidney Dis 1988; 11:473.
  114. Gejyo F, Kawaguchi Y, Hara S, et al. Arresting dialysis-related amyloidosis: a prospective multicenter controlled trial of direct hemoperfusion with a beta2-microglobulin adsorption column. Artif Organs 2004; 28:371.
  115. Abe T, Uchita K, Orita H, et al. Effect of beta(2)-microglobulin adsorption column on dialysis-related amyloidosis. Kidney Int 2003; 64:1522.
  116. Kutsuki H. beta(2)-Microglobulin-selective direct hemoperfusion column for the treatment of dialysis-related amyloidosis. Biochim Biophys Acta 2005; 1753:141.
  117. Gejyo F, Amano I, Ando T, et al. Survey of the effects of a column for adsorption of β2-microglobulin in patients with dialysis-related amyloidosis in Japan. Ther Apher Dial 2013; 17:40.
  118. Giorgetti S, Raimondi S, Pagano K, et al. Effect of tetracyclines on the dynamics of formation and destructuration of beta2-microglobulin amyloid fibrils. J Biol Chem 2011; 286:2121.
  119. Montagna G, Cazzulani B, Obici L, et al. Benefit of doxycycline treatment on articular disability caused by dialysis related amyloidosis. Amyloid 2013; 20:173.
  120. Otsubo S, Kimata N, Okutsu I, et al. Characteristics of dialysis-related amyloidosis in patients on haemodialysis therapy for more than 30 years. Nephrol Dial Transplant 2009; 24:1593.
  121. Takenaka R, Fukatsu A, Matsuo S, et al. Surgical treatment of hemodialysis-related shoulder arthropathy. Clin Nephrol 1992; 38:224.
  122. Naito M, Ogata K, Shiota E, Oyama M. Amyloid bone cysts of the femoral neck. Impending fractures treated by curettage and bone grafting. J Bone Joint Surg Br 1994; 76:922.