Kidney Information

Amyloidosis and Kidney Disease

Proteins help in constructing our body parts. It helps building the nails, hair and the bones. The blood is the medium through which the protein flows in all parts of our body. This is a harmless element present in the blood. But many times abnormal proteins are created by the human cells. These harmful agents get collected in the tissues and become a huge collection hence becoming a disease. Previously, these proteins were termed as amyloid, and the whole process as amyloidosis.

Research and studies show that amyloid deposits can be formed by various types of proteins. There are many kinds of amyloidosis. Two kinds of such proteins are nearly related to a kidney disease. During the first stages if amyloidosis abnormal protein is produced, then it gradually leads to kidney disease. A kidney disease can also cause a Dialysis-related amyloidosis (DRA).

Primary Amyloidosis

Primary amyloidosis is a condition that takes place when the cells that creates antibodies does not work properly. They create some abnormal protein fibers and are generally made up of pieces of antibodies. Many people affected with primary amyloidosis shows a state known as multiple myeloma. These antibody pieces forms amyloid deposits in various organs of the body and even the kidney. This can affect to the kidney negatively. These damaged kidneys cannot work in a right way and normally. Hence its normal functioning gets hampered. Urea and other wastes are not removed from the blood properly. Increased levels of such protein levels can also affect the brain, the heart, lungs and also the digestive system of the human body.

Kidney amyloidosis is noticed to be present when an abnormal growth in level of protein in urine is observed. This condition is known as proteinuria. If the kidneys are healthy then they stops the proteins from getting deposited in the urine. Hence when reports reveal the presence of proteins in the urine it means that the kidneys are not functioning normally. A biopsy might be done to confirm this. A small quantity of tissue is observed under a microscope and then if signs are positive amyloidosis is confirmed.

The advancement of deposition of amyloid is slowed down by various treatments and medications. Few medicines are used together to slow the growth. Drugs like melphalan which is a medicine used to treat cancer along with prednisone, an anti-inflammatory steroid drug, are used in patients to improve the functioning of the organs. Fast increment of quantity of abnormal cells producing amyloid protein is reduced. When chemotherapy medication is given the same drugs are used. Medicines like multiple myeloma can have many side effects like vomiting and nausea, fatigue or hair loss.

Many clinics have shown positive results by transplanting the patients own blood stem cells to change the affected bone marrow. High doses of melphalana are used in this kind of treatment. The side effects can also be really serious. Heart patients are not advisable to go for such treatments.

Dialysis-Related Amyloidosis

A kidney functions in removing and filtering extra proteins from the blood and hence maintaining the normal functioning of the blood vessels. Patients receiving dialysis can show the presence of a small kind or protein known as beta-2-microglobulin in the blood. Hence the beta-2-microglobulin attaches together over time. Thus, these go on adding up like chains developing into a bigger size. These big molecules affect the tissues around hence creating an uneasy situation. This is known as dialysis-related amyloidosis (DRA).

DRA is found commonly in older adults who have been on hemodialysis for more than 5 years. The Hemodialysis membranes used by the body for so many years don’t remove the big complex beta-2-microglobulin proteins efficiently from the blood. However, the new hemodialysis membranes and peritoneal dialysis removes beta-2-microglobulin more efficiently but not so good that it keeps the blood level in a normal level. Hence, the result is that blood levels increase, in the joints, bines and tendons (these are the tissue that attaches the muscles to the bones). Hence when affected with DRA a person experiences stiffness, pain and fluid accumulation in the joints. Patients can also grow cysts, hollow cavities in many parts of their bones. This can again develop into fractures in the bones unexpectedly. The tendons and the ligaments can even tear by accumulation of Amyloid deposits. A surgery can help many patients.

Many patients affected with a DRA builds up a condition known as the carpal tunnel syndrome. This is due to the collection of proteins in the wrist of a person. Certain numbness or a tingling sensation along with weakness in the muscle of the hands and the fingers can be experienced by the patients. It’s a pathetic condition.
However a cure for DRA is still to be found. A transplant of the kidney can check the advancement of the damage. The dialysis engineers are focused into this. The new dialysis membranes can take out huge amounts of beta-2-microglobulin from the blood.

New Researches

Recent years there have been a lot of researches and studies in the field of kidney diseases. The Diabetes and Digestive and Kidney Diseases (NIDDK) and The National Institute of Diabetes sponsor many seminars that explain and aware people about the disease. They give a proper idea about a kidney failure and the methods of cure.

The NIDDK's Division of Kidney, Urologic, and Hematologic Diseases sponsor the general research about the normal functioning of the kidney. They also do extensive research on the disease that causes damage to the normal functioning of the kidney at cellular or molecular levels including amyloidosis. There are some genes that these researches have revealed which genetically passes primary amyloidosis to their next generation. A group of research and developers at the Indiana University School of Medicine found mutation in the apolipoprotein A-II gene of a patient who has been diagnosed by a kidney damage that has been due to amyloidosis. This patient has reabsorbed amyloid almost full. The research unit finds out the reasons for such

re-absorption and also the probable treatment procedures. The NIDDK also helps the studies to create a blood detoxification procedure that will remove beta-2-microglobulin

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