Can the nephrologist prevent dialysis-related amyloidosis?

The pathogenesis of dialysis-related amyloidosis is still poorly understood. Therefore, preventive measures can be proposed at present only on the basis of retrospective studies and hypothetical considerations. Two main solutions may be recommended, namely an effective dialytic removal of beta 2-microglobulin (beta 2-M), which is the protein precursor of dialysis amyloid, and the avoidance of bioincompatibility-associated phenomena such as those induced by dialysis membranes and endotoxins. Promising new imaging techniques such as computed tomography (CT) scan, nuclear magnetic resonance (NMR), and scintigraphy with specific tracers for amyloid may be helpful to evaluate the long-term results of different treatment schedules, including various strategies of renal replacement therapy.