[Destructive non-infectious spondylopathy during hemodialysis]

Improvement of long-term treatment with hemodialysis requires an optimized radiological differential diagnosis of bone changes associated with long-term hemodialysis. 85 patients with chronic renal failure on maintenance hemodialysis were examined. In a conventional radiographic skeletal survey of the whole spine, 22 patients (26%) had involved intervertebral discs. The site of predilection was the cervical spine followed by the lumbar spine; oligosegmental involvement was seen in nine patients. Eighteen patients with destructive non-infectious spondyloarthropahy had juxtaarticular cystic bony changes associated with the hip, shoulder and wrist. Bone biopsy in eight patients revealed amyloid as content of these cysts. The interrelation between the duration of preterminal and terminal renal failure on one hand and destructive bone changes in the spine and cysts on the other hand seems to point to destructive spondyloarthropathy as an important complication of renal insufficiency and dialysis.