{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T01:38:50Z","timestamp":1789609130901,"version":"build-2803163510"},"reference-count":61,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,6,12]],"date-time":"2018-06-12T00:00:00Z","timestamp":1528761600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Seminars in Dialysis"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Accumulation of amyloid fibrils from \u03b22\u2010microglobulin (\u03b22M) was first recognized as a characteristic osteoarticular complication in long\u2010term hemodialysis (<jats:styled-content style=\"fixed-case\">HD<\/jats:styled-content>) patients and called \u201c<jats:styled-content style=\"fixed-case\">HD<\/jats:styled-content>\u2010related amyloidosis\u201d (<jats:styled-content style=\"fixed-case\">HRA<\/jats:styled-content>). However, this syndrome can also be observed in end\u2010stage renal diseases (<jats:styled-content style=\"fixed-case\">ESRD<\/jats:styled-content>) patients undergoing peritoneal dialysis, and even in patients with chronic renal failure <jats:italic>before<\/jats:italic> the initiation of dialytic therapy, suggesting that <jats:styled-content style=\"fixed-case\">HD<\/jats:styled-content> is not a direct cause but that accumulation of \u03b22M or some \u03b22M\u2010associated molecules in the body is a common pathogenesis. Currently the term \u201cdialysis\u2010related amyloidosis\u201d (<jats:styled-content style=\"fixed-case\">DRA<\/jats:styled-content>) is widely used for \u03b22M\u2010amyloid (A\u03b22M) amyloidosis associated with <jats:styled-content style=\"fixed-case\">ESRD<\/jats:styled-content>, although <jats:styled-content style=\"fixed-case\">DRA<\/jats:styled-content> patients consist mostly of those undergoing long\u2010term <jats:styled-content style=\"fixed-case\">HD<\/jats:styled-content>. Factors other than \u03b22M accumulation also play a role in the formation\/local deposition of A\u03b22M and disruption of tissue architecture. Conformational changes of \u03b22M by misfolding\/unfolding, and promoting\/inhibitory effects induced by other coexisting molecules, advanced glycation and oxidation, and direct cell toxicity have also been documented. Two technological improvements of <jats:styled-content style=\"fixed-case\">HD<\/jats:styled-content> have been the keys to prevent the development and progression of <jats:styled-content style=\"fixed-case\">DRA<\/jats:styled-content>: the efficient removal of \u03b22M by using high\u2010flux membranes, high\u2010volume convection and adsorptive column\/membrane, as well as the use of biocompatible membranes and dialysates (eg, ultrapure and acetate\u2010free dialysates) have minimized both inflammation and \u03b22M production. Epidemiologically, a decrease in the incidence of <jats:styled-content style=\"fixed-case\">DRA<\/jats:styled-content> has recently been reported; however, longer survival of <jats:styled-content style=\"fixed-case\">HD<\/jats:styled-content> patients may contribute to the development of more <jats:styled-content style=\"fixed-case\">DRA<\/jats:styled-content>, though with a delayed onset. In this article, we describe the pathogenesis of <jats:styled-content style=\"fixed-case\">DRA<\/jats:styled-content>, the strategies developed for its prevention and minimization, and the favorable epidemiological data achieved by these efforts.<\/jats:p>","DOI":"10.1111\/sdi.12720","type":"journal-article","created":{"date-parts":[[2018,6,13]],"date-time":"2018-06-13T00:15:20Z","timestamp":1528848920000},"page":"612-618","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Hemodialysis\u2010related amyloidosis: Is it still relevant?"],"prefix":"10.1111","volume":"31","author":[{"given":"Shuzo","family":"Kaneko","sequence":"first","affiliation":[{"name":"Department of Nephrology Faculty of Medicine University of Tsukuba Tsukuba Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunihiro","family":"Yamagata","sequence":"additional","affiliation":[{"name":"Department of Nephrology Faculty of Medicine University of Tsukuba Tsukuba Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,6,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.51.597.450"},{"key":"e_1_2_7_3_1","first-page":"1715","article-title":"Hemodialysis: carpal tunnel syndrome and amyloid substance","volume":"9","author":"Assenat H","year":"1980","journal-title":"Nouv Presse Med"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780270402"},{"key":"e_1_2_7_5_1","first-page":"291","article-title":"Carpal tunnel syndrome, shoulder pain and amyloid deposits in long\u2010term haemodialysis patients","volume":"21","author":"Charra B","year":"1985","journal-title":"Proc Eur Dial Transplant Assoc Eur Ren Assoc"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0006-291X(85)91948-5"},{"key":"e_1_2_7_7_1","first-page":"753","article-title":"Carpal tunnel syndrome and amyloidosis associated with continuous ambulatory peritoneal dialysis","volume":"139","author":"Gagnon RF","year":"1988","journal-title":"CMAJ"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(88)80082-9"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199010113231514"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1997.431"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfv276"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1997.262"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1991.128"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1110\/ps.9.5.831"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.3109\/13506129.2014.994057"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1201356"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1080\/13506120500032352"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.M110.167965"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.M113.498337"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0139330"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1159\/000169048"},{"key":"e_1_2_7_22_1","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1681\/ASN.V73472","article-title":"The effect of membrane biocompatibility on plasma beta 2\u2010microglobulin levels in chronic hemodialysis patients","volume":"7","author":"Hakim RM","year":"1996","journal-title":"J Am Soc Nephrol"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1159\/000110069"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1997.434"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-139x.2001.00026.x"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/039139880703000505"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.1999.00236.x"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-139X.2006.00134.x"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.03340509"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021583"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2008060590"},{"key":"e_1_2_7_32_1","first-page":"CD005016","article-title":"High\u2010flux versus low\u2010flux membranes for end\u2010stage kidney disease","volume":"12","author":"Palmer SC","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfu345"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000003440"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfr491"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2012080875"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nefro.2015.10.007"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfs407"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfv349"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2015.264"},{"key":"e_1_2_7_41_1","first-page":"548","article-title":"Mortality reduction by post\u2010dilution online\u2010haemodiafiltration: a cause\u2010specific analysis. HDF Pooling Project investigators","volume":"32","author":"Nub\u00e9 MJ","year":"2017","journal-title":"Nephrol Dial Transplant"},{"key":"e_1_2_7_42_1","first-page":"718","article-title":"Systemic distribution of beta 2\u2010microglobulin\u2010derived amyloidosis in patients who undergo long\u2010term hemodialysis. Report of seven cases and review of the literature","volume":"118","author":"Gal R","year":"1994","journal-title":"Arch Pathol Lab Med"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1080\/13506129.2016.1257986"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1159\/000199457"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/15.1.58"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/7.9.924"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2017.01.047"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-139x.2001.00038.x"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1594.1998.06179.x"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2003.00235.x"},{"key":"e_1_2_7_51_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1594.2004.47260.x"},{"key":"e_1_2_7_52_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-9987.2011.00937.x"},{"key":"e_1_2_7_53_1","doi-asserted-by":"publisher","DOI":"10.1159\/000330332"},{"key":"e_1_2_7_54_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1744-9987.2012.01130.x"},{"key":"e_1_2_7_55_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1993.102"},{"key":"e_1_2_7_56_1","doi-asserted-by":"publisher","DOI":"10.1038\/ki.1990.298"},{"key":"e_1_2_7_57_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2001.07816.x"},{"key":"e_1_2_7_58_1","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1681\/ASN.V72350","article-title":"Potential effect of metabolic acidosis on beta 2\u2010microglobulin generation: in\u00a0vivo and in\u00a0vitro studies","volume":"7","author":"Sonikian M","year":"1996","journal-title":"J Am Soc Nephrol"},{"key":"e_1_2_7_59_1","doi-asserted-by":"publisher","DOI":"10.1177\/039139889101401101"},{"key":"e_1_2_7_60_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/13.12.3118"},{"key":"e_1_2_7_61_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfs514"},{"key":"e_1_2_7_62_1","doi-asserted-by":"publisher","DOI":"10.1159\/000362567"}],"container-title":["Seminars in Dialysis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fsdi.12720","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/sdi.12720","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T19:39:40Z","timestamp":1694461180000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/sdi.12720"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6,12]]},"references-count":61,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2018,11]]}},"alternative-id":["10.1111\/sdi.12720"],"URL":"https:\/\/doi.org\/10.1111\/sdi.12720","archive":["Portico"],"relation":{},"ISSN":["0894-0959","1525-139X"],"issn-type":[{"value":"0894-0959","type":"print"},{"value":"1525-139X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,6,12]]},"assertion":[{"value":"2018-06-12","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}