An end-stage kidney disease patient undergoing dialysis treatment for 50 years with dialysis-related amyloidosis in multiple organs.

Abstract

Advancements in dialysis treatment have led to an increase in the number of patients undergoing long-term dialysis. These patients often experience a decline in activities of daily living (ADL) owing to various chronic kidney disease-related conditions such as mineral and bone disorders, dialysis-related amyloidosis (DRA), and cardiovascular diseases. A male patient began hemodialysis at the age of 22 years because of end-stage kidney disease caused by chronic glomerulonephritis and continued dialysis treatment for 50 years. The patient died at 72 years of age from sepsis, ischemic colitis, and pneumonia. During the course of treatment, the patient frequently underwent surgeries for carpal tunnel syndrome and destructive spondyloarthropathy, which led to a decline in ADL. An autopsy revealed β₂-microglobulin amyloid deposits in multiple organs, including the heart, lungs, and intestines. Long-term dialysis treatment results in ADL impairment owing to osteoarticular disorders caused by DRA, and systemic organ deposits are potentially related to organ failures such as ischemic colitis and pneumonia. Elucidating the pathophysiology of DRA and developing more effective treatments may improve ADL and prognosis in patients undergoing long-term dialysis.