Hip arthropathy associated with hemodialysis. Radiological and laboratory evaluation of 56 hemodialysis patients

There were 56 consecutive patients enrolled in our study from the outpatient clinic of our institution, mean age of 59 years, who had been on hemodialysis for 2-26 years. The duration of hemodialysis was less than 10 years for 36 patients (short-term group) and 10 years or more for 20 patients (long-term group) with a mean duration of 11 years at time of the investigation. In the short-term group, plain radiography revealed bone cysts in 9 hips (17%) and joint space narrowing in 10 hips (19%), while in the long-term group, there were bone cysts in 19 hips (48%) and joint space narrowing in 6 hips (15%). Bone mineral density as determined by dual-energy X-ray absorptiometry was 0.621 g/cm2 for patients in the short-term group and 0.503 g/cm2 for patients in the long-term group. Hip arthroplasties were performed in 3 patients suffering from femoral neck fracture due to bone cysts. All of them showed marked bone loss (mean 0.380 g/cm2). In conclusion, plain radiography and dual-energy X-ray absorptiometry are useful for evaluating the hip arthropathy of hemodialysis patients, especially those who have undergone long-term hemodialysis.