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Article Review/Hyperlink
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Tan SY, Irish A, Winearls CG, Brown EA, et al.
Long term effects of renal transplantation on dialysis-related
amyloid deposits and symptomatology
Kidney Int
(Jul) 50:282-289 1996

In 1990 members of this group described a technique in NEJM to evaluate the
extent of dialysis-related amyloidosis (DRA) using 123-I-labeled serum
amyloid P component. They now use this technique, plus clinical and
radiologic assessment, to determine what happens to DRA after renal
transplantation.
Fifteen long term (18 years median) HD patients were studied prospectively
over 5 years, during which time 9 were transplanted. In the transplanted
group there was marked clinical, scintigraphic, and mild radiographic
improvement, whereas in the non-transplanted group there was considerable
progression of disease. SAP scintigraphy was found to be useful to detect
silent amyloid disease.
Comment: The results are significant in that they suggest that even
severe DRA is potentially reversible, certainly with transplantation, and
possibly with very high flux hemodiafiltration (although the latter remains
to be more thoroughly investigated).
(John T. Daugirdas, MD, University of Illinois at Chicago)
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