OUTCOME OF DIALYSIS-ASSOCIATED ARTHROPATHY AND DIALYSIS-RELATED BETA-2-MICROGLOBULIN AMYLOIDOSIS AFTER RENAL-TRANSPLANTATION

The time-course of clinical symptoms and radiological changes due to d ialysis-associated arthropathy was studied in six patients who underwe nt renal transplantation after more than ten years on hemodialysis. Af ter a mean followup of 55 months, all the patients reported relief of shoulder pain. The number and size of juxtaarticular bony cysts or ero sions in the limbs remained unchanged. In sharp contrast with this sta bility, progression of destructive seen in one patient 75 months after renal transplantation. In two patients, persistent beta 2-microglobul in deposits were seen in synovial specimens removed surgically from th e hip two and 121 months, respectively, after renal transplantation. W e conclude that (1) renal transplantation is followed by rapid relief of pain due to dialysis-associated arthropathy; (2) cystic bone lesion s in the limbs persist, with no evidence of progression, up to ten yea rs after renal transplantation; (3) destructive spondyloarthropathy ca n progress in renal transplant recipients; (4) beta-2-microglobulin am yloid deposits persist up to ten years after successful renal transpla ntation.