Which surgical procedures may be beneficial in the treatment of dialysis-related beta-2-microglobulin (beta-2m) amyloidosis?

Updated: Nov 14, 2019
  • Author: Anita Basu, MD, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Surgical intervention may be effective in alleviating pain and restoring function. Procedures include the following:

  • Carpal tunnel release with surgical decompression of the median nerve or release of the transverse carpal ligaments under endoscopic visualization
  • Flexor tenosynovectomy or percutaneous first annular pulley release
  • Spinal stabilization or laminectomy
  • Total joint replacement

Unfortunately, orthopedic interventions have high failure rates in dialysis-related amyloidosis (DRA) compared with rates in the general population. If, during the course of a surgery, beta-2m amyloidosis is suspected, then a biopsy should be performed at that time.


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