[Diagnostic and therapeutic aspects of dialysis-related amyloidosis].

: The definitive diagnosis of dialysis-related amyloidosis based on histologic findings suffers from invasive surgical procedure and punctual information. Imaging techniques: ultrasonography, X-ray, computed tomography or magnetic resonance are relatively nonspecific and not sensitive enough. Scintigraphy using radio-labelled beta-2-microglobulin currently represents the most specific method to noninvasively diagnosis dialysis-related amyloidosis. Available therapeutic methods include the removal of BMG and palliation of symptoms. Hemodialysis high-flux and hemodiafiltration based on convection are more effective in elimination of BMG than standard hemodialysis with diffusive transport as a dominant mechanism. Use of the adsorption columns Lixelle reduces plasma BMG concentration and leads to clinical improvement of DRA. Medical therapy consists of the use of low dose corticosteroids and non-steroidal anti-inflammatory drugs. Surgical therapy is often necessary in the late stages of DRA. Renal transplantation is still the optimal method of DRA treatment.