RHEUMATOLOGICAL COMPLICATIONS OF DIALYSIS

The articular complications observed in dialysed chronic renal failure failures, whose incidence increases with the duration of dialysis, ar e closely correlated with the development of beta2-microglobulin amylo idosis, responsible for nerve tunnel syndromes, arthralgia and chronic joint swelling with frequently multiple subchondral cysts on x-rays. Microcrystalline pathology is dominated by apatite deposits, which may also be involved in the pathogenesis of destructive arthropathy. Arti cular complications with destruction of the large joints or involvemen t of the first carpometacarpal joint interfere with the functional pro gnosis. Sepsis must be excluded in cases of destructive cervical spond yloarthropathies. The pathogenesis of destructive arthropathies is pro bably multifactorial, consisting of apatite and amyloid deposits, seco ndary hyperparathyroidism and aluminium poisoning.