Zingraff J, Drüeke T
INSERM Unité 90, Hôpital Necker, Paris, France.
Am J Kidney Dis. 1991 Jul;18(1):1-11. doi: 10.1016/s0272-6386(12)80283-6.
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.
透析相关淀粉样变性的发病机制仍未被充分理解。因此，目前只能基于回顾性研究和假设性考量提出预防措施。可能推荐两种主要的解决办法，即有效透析清除β2微球蛋白（β2-M），它是透析淀粉样蛋白的蛋白质前体，以及避免生物不相容性相关现象，如透析膜和内毒素所引发的那些现象。诸如计算机断层扫描（CT）、核磁共振（NMR）以及使用针对淀粉样蛋白的特异性示踪剂的闪烁扫描等有前景的新成像技术，可能有助于评估不同治疗方案的长期效果，包括各种肾脏替代治疗策略。
