PREVALENCE OF DIALYSIS-RELATED AMYLOIDOSIS IN DIABETIC-PATIENTS

It has recently been shown that beta(2)-microglobulin isolated from am yloid deposits in dialysis patients is modified by advanced glycation (AGE). In this context it appeared of interest to examine in a cross-s ectional multicentre study whether dialysis-related amyloidosis, as ev aluated by X-ray assessment of cysts in the metacarpal bones, was diff erent in diabetic patients on maintenance haemodialysis for more than 5 years time compared with matched nondiabetic controls. We evaluated the hand skeleton of 75 diabetic patients (9 type I, 66 type II; 35 ma le, 40 female; median age 64 years, range 31-86; median duration of di alysis 7 years, range 5-17), They were compared with 150 patients with out diabetes mellitus who were matched for age, gender and duration of dialysis. Hand X-rays were centrally evaluated by one radiologist una ware of the underlying clinical diagnosis. The overall frequency of am yloid cysts was 9/75 (12%) in diabetic patients (95% confidence interv al 4.6-19.3%) and 28/150 (19%) in matched controls (95% confidence int erval 12.4-24.9%). The results indicate that diabetes mellitus does no t confer an increased risk of dialysis-related amyloid cysts. The resu lts are of interest with respect to the mechanism of amyloid formation .