MP700MUSCULOSKELETAL MANIFESTATIONS IN HEMODIALYSIS PATIENTS AND ASSOCIATED FACTORS

Abstract

INTRODUCTION AND AIMS: The number of patients suffering from chronic kidney disease (CKD) stage 5 increased constantly during the past decades. However, despite all the improvements in the technique, dialysis related osteoarthropathy is still a major problem in long-term hemodialysis patients. Bone and joint diseases range from simple pain to major disability. Frequency and severity of these manifestations increase with the length of the dialysis especially in those who are undergoing hemodialysis for more than 30 years. The aim of this study was to estimate the prevalence of musculoskeletal manifestations in hemodialysis patients and to identify associated factors. METHOD(S): We performed a cross-sectional study, in the hemodialysis unit at Hotel- Dieu de France Hospital in Beirut. All adult patients in the center were included (N=91). For each patient, we filled a data collection sheet including basic demographic characteristics, osteoarticular symptoms, biologic parameters and treatments. Osteoarticular symptoms were classified into syndromes and diagnostic categories by rheumatology specialists. RESULT(S): Mean age was 68 612 years. 36.9% were female. Dialysis vintage was 5.69+/-5.36 years. Musculoskeletal symptoms were reported by 56.04% of the patients. Arthralgia was the most frequent symptom (72.7%). The main diagnoses related to the different symptoms were osteoarthritis (37.4%), carpal tunnel syndrome (15.4%), osteoporotic fracture (13.2%) and tendinopathy (12.1%). We found a significant association between the prevalence of musculoskeletal symptoms and the dialysis vintage (p=0.02). The number of years in dialysis was significantly associated with the diagnosis of osteoarthritis (p<0,001), fractures (p<0.01), carpal tunnel syndrome (p<0.01) and chondrocalcinosis (p=0.01). Serum phosphorus was found to be significantly associated with the carpal tunnel syndrome (p=0.031) CONCLUSION(S): Musculoskeletal manifestations are highly prevalent (56%) in the hemodialysis population. Dialysis vintage is a predictive factor of the onset of these manifestations and is particularly associated with the diagnosis of osteoarthritis, carpal tunnel syndrome, fractures and chondrocalcinosis. Carpal tunnel syndrome may also be associated with the serum phosphorus; this finding needs to be confirmed by further studies on a larger scale.