Bone cysts and continuous ambulatory peritoneal dialysis

The clinical and radiologic patterns of amyloid osteoarthropathy in long-term hemodialysis patients are well known. However, few studies about the incidence of dialysis-associated amyloidosis in continuous ambulatory peritoneal dialysis (CAPD) patients have been published to date. In a series of 27 CAPD patients, the authors found bone cysts in 63.6% of cases, at the beginning of their dialysis treatment. After a mean follow-up period of 20.9 +/- 13.8 months, carpal bone cysts were seen in 70.4% of cases and clinical patterns worsened in 26.3% of patients. Therefore, CAPD does not prevent the development of dialysis-associated amyloidosis; prolonged uremic state and decreased diuresis seem to be the main pathogenetic factors of osteoarthropathy. The incidence and the evolution of bone lesions were related to the clinical data of this series and then compared with those of a group of hemodialysis patients. This study confirms that plain wrist films are a simple and useful method in the early detection and in the follow-up of amyloidosis-related disease.