Case 7: Dialysis Related Amyloidosis

“Ouch my wrist hurts.” Your nephrologist may be able to help.

You see an 82 year old African American male with history of ESRD secondary to polycystic kidney disease, who has been on hemodialysis for the last 12 years via a left brachiocephalic AVF. He is otherwise in surprisingly good health and very functional. While you are rounding in the dialysis unit, he tells you that he has been having left shoulder and left wrist pain and was told that he may have carpal tunnel syndrome in his left wrist. You are concerned that he may be developing dialysis related amyloidosis.