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Spondyloarthropathy from long-term hemodialysis.
J B Naidich1, R T Mossey, B McHeffey-Atkinson
1Department of Radiology, North Shore University Hospital, Manhasset, NY 11030.
Radiology
|June 1, 1988
Summary
Long-term hemodialysis patients with hand abnormalities may develop concurrent spinal disease, resembling destructive spondyloarthropathy. This skeletal response to chronic renal failure and dialysis may increase with duration of treatment.
Area of Science:
- Nephrology
- Rheumatology
- Radiology
Background:
- Patients undergoing long-term hemodialysis can develop various complications.
- Hand and wrist abnormalities are known in this patient population.
- Concurrent spinal disease has not been extensively studied in these patients.
Purpose of the Study:
- To investigate the prevalence of spinal disease in hemodialysis patients with hand and wrist abnormalities.
- To characterize the nature of any observed spinal disease.
- To explore potential associations with hemodialysis duration and extent of skeletal involvement.
Main Methods:
- Radiographic examination of the spine in 26 hemodialysis patients with hand/wrist abnormalities.
- Comparison with spinal radiographs of 31 control patients with normal hands/wrists.
- Postmortem examination in two cases of spondyloarthropathy.
Main Results:
- Six of 26 patients (23%) showed spinal disease.
- Findings included destructive spondyloarthropathy (4 patients) and erosive arthritis (2 patients).
- No spinal abnormalities were found in the control group.
Conclusions:
- A skeletal response to chronic renal failure and long-term hemodialysis, similar to hand/wrist disease, is identified.
- The condition may be more prevalent with longer dialysis duration and widespread skeletal involvement.
- The disease is likely not infectious, even with multifocal involvement.