Low-dose steroid treatment for dialysis-related amyloid arthropathy

Abstract

In order to know the present state of low-dose steroid treatment for articular symptoms of dialysis-related amyloidosis, we have carried out a questionnaire survey for 102 facilities. These facilities were chosen from training facilities of the Ministry of Health and Welfare of Japan for people who are engaged in dialysis medicine, and facilities authorized by the Japanese Society for Dialysis Therapy, one from each prefecture. We have received answers from 78 facilities (76.5%). In these facilities, there were 10, 760 patients of dialysis, 2, 912 of them had received dialysis treatment over ten years, and 1, 225 of them had complications of dialysis-related amyloidosis. Among the 68 facilities in which complications of dialysis-related amyloidosis were reported, 56 facilities, more than 80%, had carried out medication for arthralgia of dialysis-related amyloidosis and only 12 ones did not do this treatment. Adrenocortical steroid (steroid) had been used in 33 of the 68 facilities (48.5%), and 140 patients had been treated with steroid. This was 11.4% of the total 1, 225 patients of dialysisrelated amyloidosis. On the side effects of steroid treatment, 15 cases were reported from 8 facilities out of 33 facilities. The most noticeable side effects were the 3 cases of infection, one was dead, the other two had to be in hospital for several weeks. On steroid treatment for dialysis patients, it is necessary to pay attention to infection, and to adjust the adaptation to an appropriate level. Our research team has proposed a guideline, that is, “the guideline to the low-dose steroid treatment on articular symptoms of dialysis-related amyloidosis”, which is very helpful to this respect.