The unresolved problem of beta-2 microglobulin amyloid deposits in the intervertebral discs of long-term dialysis patients

Tsung Ting Tsai*, Arun Kumar Kaliya-Perumal, Chang Chyi Jenq, Chi Chien Niu, Natalie Yi Ju Ho, Tung Ying Lee, Po Liang Lai

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

10 Scopus citations


Background: Dialysis-related destructive spondyloarthropathy caused by beta-2 microglobulin (β2M) amyloid deposits in intervertebral discs is a major burden for patients undergoing long-term dialysis. This study aimed to quantify the presence of β2M amyloid deposits in the intervertebral disc tissue of such patients and analyze whether there was a significant correlation between β2M accumulation and the duration of dialysis. Methods: Two groups of patients who had undergone surgery for degenerative spinal pathologies were selected: the dialysis group (n = 29) with long-term dialysis and the control group (n = 10) with no renal impairment. Tissue sections were prepared from specimens of intervertebral disc tissue obtained during spinal surgery and analyzed via histological staining, including immunohistochemistry (IHC) and Congo red. Results: There was a statistically significant multifold increase of β2M expression in the disc tissue of long-term dialysis patients when compared to non-dialysis patients, as shown by both IHC (0.019 ± 0.023 μm2 vs. 0.00020 ± 0.00033 μm2, respectively; p = 0.012) and Congo red staining (0.027 ± 0.041 μm2 vs. 9.240 × 10-5 ± 5.261 × 10-5 μm2, respectively; p = 0.047). We also note a moderate strength positive correlation between the duration of dialysis and positive IHC (r = 0.39; p = 0.015) and Congo-red staining (r = 0.42; p = 0.007). Conclusions: The problem of β2M amyloidosis in long-term dialysis patients remains unresolved even with predominant use of high-flux dialysis membranes. This highlights the insufficiency of current dialysis modalities to effectively filter β2M.

Original languageEnglish
Article number194
JournalJournal of Orthopaedic Surgery and Research
Issue number1
StatePublished - 21 12 2017

Bibliographical note

Publisher Copyright:
© 2017 The Author(s).


  • Amyloid
  • Beta-2 microglobulin
  • Congo red
  • Dialysis
  • Intervertebral disc
  • Spondyloarthropathy


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