Spontaneous rupture of the quadriceps tendon in renal failure and long-term haemodialysis

Spontaneous Rupture of Tendons

“…Sporadic cases have been reported, some of them associated with arteriosclerosis and diabetes mellitus [9], primary hyperpara thyroidism [10,11], secondary hyperparathy roidism [4], hemodialysis [2][3][4] It is both striking and impressive that in our small group of 50 patients treated by chronic hemodialysis, there were 7 cases of ruptured tendons, in 3 of which simultaneous rupture of two tendons occurred. Is this prevalence due to some local factor, or are we more aware of the presence of this complication?…”

“…Lotem et at. [3] found evidence of elastosis in the biopsy material taken from the ruptured tendons of case 3 and from the case of Levy et al [12] where the weakening of the tendons was originally attributed to uric acid.…”

“…A high propor tion of the published cases of bilateral simul taneous rupture of the quadriceps occurred in renal disease [2][3][4]13,14]. Even the patient of Levy et al [12] where the tear was attributed to gout, was in terminal renal failure with a blood urea of 210 mg%.…”

“…The first 4 have been previously reported [2,3], Hemodialysis was given for 5 h, three times a week, using a coil system with Travenol RSP. These patients were on a 1 g/kg protein diet, and in addition received vitamin B complex, folic acid and aluminium hydrox ide.…”

“…being treated by hemodialysis [I], Rupture of major tendons (RMT) is a less known problem in these patients, a few case reports having been reported in the pertinent literature [2,3].…”