M. Jadoul et al., PREVALENCE OF HISTOLOGICAL BETA-2-MICROGLOBULIN AMYLOIDOSIS IN CAPD PATIENTS COMPARED WITH HEMODIALYSIS-PATIENTS, Kidney international, 54(3), 1998, pp. 956-959
Background. The prevalence of beta 2-microglobulin amyloidosis (A beta
(2)m) in patients on continuous ambulatory peritoneal dialysis (CAPD)
is unknown. Methods. We prospectively obtained a median of 2 (range 1
to 4) joint samples from 26 CAPD patients aged 44 to 93 (median 73) ye
ars at post-mortem evaluation after 4.5 to 126 (median 27) months sole
ly on CAPD (N = 19) or primarily on CAPD (that is, less than or equal
to 10% and less than or equal to 1 year of renal replacement therapy t
ime on other modalities: N = 7). The diagnosis of A beta(2)m rested on
Congo red staining (typical birefringence) and positive immunostainin
g of amyloid deposits by a monoclonal anti-beta(2)m antibody. Results.
A beta(2)m was diagnosed in 8 of 26 patients (31%). Prevalence ranged
from 20% (2 of 10 patients) within less than or equal to 24 months CA
PD to 30% (3 of 10 patients) after 24 to 48 months and 50% (3 of 6 pat
ients) after 49 to 126 months (P = 0.11). The prevalence of A beta(2)m
was similar in patients without or with one or more peritonitis episo
des. No significant difference in prevalence (P = 0.118) was found bet
ween CAPD patients (8 +/26; 31%) and hemodialysis patients (13+/26; 50
%) carefully matched for time on dialysis and age at the onset of dial
ysis. Conclusions. The prevalence of histological A beta(2)m reaches 3
1% after a median duration of 27 months of CAPD. This prevalence is no
t significantly different from that observed in a group of HD patients
matched for age and dialysis duration.