Chronic arthropathy in long-term hemodialysis

Goldstein, Susan A.; Winston, Eileen; Chung, Tai Jin; Chopra, Shreekant; Pariser, Kenneth M.

doi:10.1016/0002-9343(85)90466-8

Cited by 53 publications

(16 citation statements)

References 9 publications

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“…Some authors have frequently seen microcrystal deposits in the peripheral joints and in the spine of hemodialyzed patients [5,8,10,16,18]. At first, these crystal deposits, particularly those of hydroxyapatite, were considered to be the cause of the spondyloarthropathy; later, this hypothesis was not confirmed, and amyloidosis of the intervertebral discs and perivertebral ligaments was held to be responsible [4,9,12,15,24,25].…”

Section: Discussionmentioning

confidence: 99%

Destructive spondyloarthropathy and radiographic follow-up in hemodialysis patients

et al. 1990

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Nine patients undergoing regular dialytic treatment for more than 60 months showed clinical and radiologic features of a noninfective and destructive spondyloarthropathy. The cervical spine was most affected (100%), followed by the dorsal (three patients, 33.3%) and the lumbar spine (two patients, 22.2%). Typically, radiographs and CT scans revealed narrowing of intervertebral spaces, with destruction or sclerosis of the subchondral bone of the vertebral plate. Autopsy was performed on three patients; histologic study demonstrated the presence of large amyloid deposits containing beta 2-microglobulin (beta 2-m) in the discs and peridiscal ligaments. A radiographic follow-up of the cervical spine was performed in seven patients after a period of 12 months and showed that the bone destruction in DSA is very rapid and progressive. The lower biocompatibility of the cuprophan membranes of dialyzers is probably the factor most responsible for hyperproduction of beta 2-m and subsequently osteoarticular deposition of a new type of amyloidosis.

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Section: Discussionmentioning

confidence: 99%

Destructive spondyloarthropathy and radiographic follow-up in hemodialysis patients

et al. 1990

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“…(5) The US National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) published clinical practice guidelines provided recommended target ranges for various markers of MBD, such as iPTH 150-300 pg/mL, total serum calcium <10.2 mg/dl, serum phosphate< 5.5 and the Ca x P at <55 mg 2 /dL 2 (6) Rheumatic disorders are major complications of renal disease, and approximately two-thirds of HD patients develop musculoskeletal problems and that incidence rises with time on dialysis (7). These include renal osteodystrophy, avascular necrosis of bone, crystal induced arthritis, periarticular calcification, (8) and recurrent haemarthrosis of shoulders (9), carpal tunnel syndrome (CTS), (10) chronic large joint arthropathy (11) and bone cysts, and have also been recognized as a major complications of CKD. Recent studies have demonstrated the deposition of amyloid in the carpal tunnel, bone cysts, synovium, and tendons of such patients.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Chronic Kidney Disease - Mineral and Bone Disorder on the Locomotor System and Quality of Life in Hemodialysis Patients

Fouad¹,

Boraie²

2015

Turk Neph Dial Transpl

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OBJectIVe: Chronic kidney disease -mineral and bone disorder (CKD -BMD) is a worldwide challenge in hemodialysis patients (HD). Widespread use and improved methods of HD may have changed the spectrum of locomotor system disorders in this population. Locomotor system disorders have an impact on health-related quality of life (QOL). The objective of this study was to assess the effect of CKD-BMD on the locomotor system (bone, joint, muscle, tendon and bursa) and document the prevalence of locomotor system disorders in HD populations and its impact in QOL. MAterIAL and MetHOds:550 HD patients were enrolled in this study. Each HD patient received complete locomotor system examination and specific diagnostic investigation. iPTH level classified study population into three groups. Group 1. (149 patients) iPTH level < 100 pg/ml, low-turnover renal osteopathy, Group 2. (126 patients) iPTH from 150-300 pg/mL, Group 3. (275 patients) iPTH > 300 pg/ mL, high turnover bone disease. Patients were offered a self-administered QOL questionnaire, which assessed various QOL variables. resuLts: 75% of hemodialysis patients suffered from one or more locomotor system disorders and the commonest was bone pain 60%, followed by muscle cramps 36%, proximal muscle weakness 30%, osteoarthritis 25%, osteoporosis 16%, rotator cuff syndrome15%, gout pre-HD 12.5%, carpal tunnel syndrome 12%, bone fracture 7%, fibromyalgia 7%, tenosynovitis 6%, periarticular calcification 5%, Dupuytren's contracture 2%, septic arthritis 0.9% and osteomyelitis 0.9%. The three studied groups were represented by 27%, 23% and 50% respectively. The prevalence of osteoarthritis, muscle cramps, bone pain, spontaneous bone fracture and osteoporosis were higher in the third group. 30% of our HD patients completed the QOL questionnaire without assistance and their mean functional status, psychological status, pain scale, fatigue scale, global assessment and joint count were 3.24±2. 24, 3.13 ±1.67, 4.07 ±1.7, 4.95 ±1. 8, 3.97 ±1.55 and 9.65±9.95 respectively. QOL variables pronouncedly worsen in HD patients, however the second group patients have a better quality of life than other groups (P<0.001).cONcLusION: Locomotor system involvement is still very common in our HD patients, especially in high turnover bone disease group and can compromise the QOL.

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“…Regardless of renal disease etiology, musculoskeletal symptoms have been reported in up to 82% of patients receiving hemodialysis [ 1 ], with increasing incidence during long-term maintenance hemodialysis [ 2 ]. These rheumatic disorders have been well described and carefully studied for many years ( Table 1 ).…”

Section: Introductionmentioning

confidence: 99%

Non-crystalline and crystalline rheumatic disorders in chronic kidney disease

Sarraf¹,

Kay²

2008

Curr Rheumatol Rep

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Rheumatic syndromes are cause for morbidity in patients with end-stage renal disease. Recent advances in understanding the role of tissue remodeling have provided insight into the pathogenic mechanisms responsible for some of these manifestations. Here, we survey recent and clinically relevant advances in translational research that impact our understanding of rheumatic syndromes seen in patients with significant renal disease. The management of acute and chronic crystalline arthropathies in chronic kidney disease and hemodialysis patients is discussed.

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Chronic arthropathy in long-term hemodialysis

Cited by 53 publications

References 9 publications

Destructive spondyloarthropathy and radiographic follow-up in hemodialysis patients

Destructive spondyloarthropathy and radiographic follow-up in hemodialysis patients

The Impact of Chronic Kidney Disease - Mineral and Bone Disorder on the Locomotor System and Quality of Life in Hemodialysis Patients

Non-crystalline and crystalline rheumatic disorders in chronic kidney disease

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