Abstract
We performed Dylon, Aluminon and Berlin blue staining of bone specimens obtained by ilium bone biopsy from 15 patients before the introduction of hemodialysis.
The patients had no subjective symptoms relating to the bones or joints. Amyloid was present in all 15 patients, aluminium in 8 and iron in 8.
The result revealed that amyloid deposition had already begun in the early stage. The involvement of other factors with aluminium deposition was strongly suspected because aluminium hydroxide gels were not taken.
Furthermore, the staining of amyloid, aluminium and iron was divided into three grades and their relation with serum β2-microglobulin, aluminium and ferritin levels was examined, but there was no significant relation with individual staining, statistically.
The presence of false negative cases was forlseen and localization of aluminium and iron in the inside of bone was presumed from the fact that there were Aluminon-positive cases, although their serum aluminium level was below the limit of determination, cases in which the serum ferritin level was normal and the test for Berlin blue staining was positive, and those in which the serum ferritin level was abnormally high, but the test for Berlin blue staining was negative. Thus, it is possible that, when the duration of hemodialysis is prolonged, amyloid-related, aluminium-related and iron-related bone disease will appear in all patients, because depositions of amyloid, aluminium and iron were already present in the bone even though no clinical symptoms had been observed before the introduction of hemodialysis.
