Destructive spondyloarthropathy in short term chronic ambulatory peritoneal dialysis and hemodialysis

Of the many rheumatic manifestations of kidney failure treated by longterm dialysis, a destructive spondyloarthropathy has recently been recognized. We performed a survey of our small, relatively short term (3-year average) dialysis population of 45 patients to establish a prevalence figure and establish a data base to assess risk factors. Destructive spondyloarthropathy was seen in 4 of 34 patients receiving hemodialysis and in 2 patients receiving chronic ambulatory peritoneal dialysis (CAPD). Age of the patient (p less than 0.09) and duration of dialysis (p less than 0.05) seem to be associated risk factors. Although it may be coincidental, radiological and biochemical hyperparathyroidism can be clearly dissociated from destructive spondyloarthropathy. The very peculiar quasiconstant, asymptomatic and early cervical localization of destructive spondyloarthropathy suggests a local mechanical factor accentuated by crystal and/or amyloid deposition disease which may become overwhelming as survival is prolonged.