OUTCOME OF DIALYSIS-ASSOCIATED ARTHROPATHY AND DIALYSIS-RELATED BETA-2-MICROGLOBULIN AMYLOIDOSIS AFTER RENAL-TRANSPLANTATION

The time-course of clinical symptoms and radiological changes due to dialysis-associated arthropathy was studied in six patients who underwent renal transplantation after more than ten years on hemodialysis. After a mean followup of 55 months, all the patients reported relief of shoulder pain. The number and size of juxtaarticular bony cysts or erosions in the limbs remained unchanged. In sharp contrast with this stability, progression of destructive seen in one patient 75 months after renal transplantation. In two patients, persistent beta 2-microglobulin deposits were seen in synovial specimens removed surgically from the hip two and 121 months, respectively, after renal transplantation. We conclude that (1) renal transplantation is followed by rapid relief of pain due to dialysis-associated arthropathy; (2) cystic bone lesions in the limbs persist, with no evidence of progression, up to ten years after renal transplantation; (3) destructive spondyloarthropathy can progress in renal transplant recipients; (4) beta-2-microglobulin amyloid deposits persist up to ten years after successful renal transplantation.