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Growing bone cysts in long-term hemodialysis
J L Gielen1, M T van Holsbeeck, D Hauglustaine
1Department of Radiology, University Hospitals, K.U. Leuven, Belgium.
Skeletal Radiology
|January 1, 1990
Summary
Long-term hemodialysis patients developed more numerous and larger subchondral cysts, particularly in the wrist. Soft tissue swelling was also observed, linked to amyloid deposition in many cases.
Area of Science:
- Nephrology
- Rheumatology
- Radiology
Background:
- Chronic renal failure patients on long-term hemodialysis often experience skeletal complications.
- Subchondral cysts and soft tissue swelling are potential manifestations.
Purpose of the Study:
- To investigate the prevalence, characteristics, and progression of subchondral cysts in patients undergoing long-term hemodialysis.
- To assess the association between these cysts, soft tissue swelling, and amyloid deposition.
Main Methods:
- Retrospective study of 21 hemodialysis patients with over 10 years of treatment.
- Analysis of serial skeletal surveys, including wrist measurements and comparison with controls.
- Radiographic and ultrasonic assessment of soft tissue swelling; biopsy and fluid analysis for amyloid.
Main Results:
- Subchondral cysts increased in size and number in the wrist, humeral head, hip, and patella over time.
- Dialysis patients showed significantly more wrist cystic involvement, larger cysts, and greater numbers compared to controls.
- Soft tissue swelling was present in dialysis patients, correlating with swollen joints, periarticular cysts, and amyloid deposition (B2 microglobulins).
Conclusions:
- Long-term hemodialysis is associated with the development and progression of subchondral cysts.
- Amyloid deposition, specifically B2 microglobulins, may contribute to joint swelling and cyst formation in these patients.