Fabry disease is a progressive devastating disease caused by absent or deficient activity of lysosomal enzyme alphagalactosidase
A, with progressive accumulation of globotriaosylceramide (GL-3) within lysosomes in a different cell types. Accumulation
of GL-3 and related glycosphingolipids in different cell types may create diverse clinical picture depending on the organ which is
dominantly affected. Renal pathology progresses in severity with aging. Globotryaosil ceramide deposits may be found in different cell
types within the kidney. Deposition within the glomeruli may be found in endothelial cells, mesangial cells, interstitial cells, with the
highest level found within the podocytes.
Although Fabry disease is not curable at the moment, availability of enzyme replacement therapy made it possible to treat this group of
patients. Two formulations of recombinant human alpha-galactosidase A are present on the market: agalsidase alfa and agalsidase beta.
Longer follow-up period is necessary to estimate the impact of ERT on mortality.
Patients with end-stage renal disease caused by Fabry disease could be safely treated with enzyme replacement therapy regardless of the
method of renal replacement therapy.