Increased risk of dialysis-related amyloidosis in patients with the apolipoprotein E4 allele

We previously developed a monoclonal antibody recognizing apolipoprotein E in all types of systemic amyloidosis, including dialysis-related amyloidosis. This suggests that apolipoprotein E is a common constituent of amyloid fibrils. In the present study, we analyzed the serum level of apolipoprotein E, the apolipoprotein E phenotypes and the corresponding allele frequencies in 97 patients undergoing chronic hemodialysis with and without dialysis-related amyloidosis, and in 173 healthy controls. The serum concentrations of apolipoprotein E in the patients with amyloidosis did not differ from those in the other hemodialysis patients and in healthy controls. However the apolipoprotein E3/4 phenotype was significantly more common (p<0. 05) in the group with amyloidosis (32.0%) than in the healthy controls (13.9%). The frequency of the apolipoprotein E4 allele was significantly greater (p<0. 01) in the group with amyloidosis (0.22) than in the group without amyloidosis (0.08) or in healthy controls (0.09). Results indicate that the apolipoprotein E4 allele may be a risk factor for the development of amyloidosis in patients receiving chronic hemodialysis.