Articular and skeletal affection in regularly dialyzed patients with end-stage renal disease
المؤلفون المشاركون
Abd al-Wahhab, Hisham E.
Abd al-Aziz, Tariq M.
al-Sayyad, Muhammad M.
Berengy, Mahmud S.
المصدر
Egyptian Rheumatology and Rehabilitation
العدد
المجلد 46، العدد 3 (30 سبتمبر/أيلول 2019)، ص ص. 162-169، 8ص.
الناشر
الجمعية المصرية للروماتيزم و التأهيل
تاريخ النشر
2019-09-30
دولة النشر
مصر
عدد الصفحات
8
التخصصات الرئيسية
الموضوعات
الملخص EN
Background Patients on regular hemodialysis (HD) are vulnerable to develop different articular and skeletal problems that interfere with life quality and affect morbidity and mortality in these patients.
To, properly, overcome or even prevent the development of these complications, early detection, especially of the commonly affected parts, is required.
Aim The aim was to detect articular and skeletal manifestations in patients with end-stage renal disease on regular HD, their relation to duration of dialysis, and which is more affected.
Patients and methods A total of 50 patients (34 males and 16 females) with end-stage renal disease on regular HD, who were attendants of the dialysis unit of Internal Medicine Department at Al-Azhar University hospital, New Damietta, with duration of dialysis ranging between 3 and 15 years and age ranging from 26 to 70 years old were recruited for the study.
They were classified into three groups: group I: mild, group II: moderate, and group III: severe joint affection.
Full history taking, thorough clinical examination, especially for uremic and rheumatologic manifestations; laboratory investigations (inflammatory and metabolic markers); synovial fluid analysis and culture; and radiological investigations (radiography, dual-energy X-ray absorptiometry scan, ultrasound, computed tomography, and MRI of the affected parts) were done.
Results There was a significant association between the duration of dialysis and the presence of joint affection.
The most common affected joints were knee joints [n=23 patients (46%)] and shoulder joints [n=10 (20%)].
There was a statistically significant association between the severity of joints involvement and the prolonged duration of dialysis.
The most common crystals present were the urate crystals (26%) followed by calcium pyrophosphate dihydrate (12%), and lastly oxalate crystals (8%).
Carpal tunnel syndrome was diagnosed in 12 patients, with high significant association between the duration of dialysis and presence of carpal tunnel syndrome.
There was increase in the level of parathyroid hormone with increase in the duration of renal dialysis.
Moreover, 64% of patients had hyperparathyroid bone disease.
The mean alkaline phosphatase level was increased in all groups of patients but was more in patients with severe joint affection.
Serum albumin was maintained within normal level in HD patients.
Radiological study of our HD patients showed that the most frequent radiological findings were signs of secondary hyperparathyroidism (subperiosteal resorption; acroosteolysis in the terminal tufts; pathological fracture, with two fractures in the spine, one in the neck of femur, and one fracture in the rib; and periarticular calcification, with one was found in the hand, and two were found in the pelvis).
The incidence of these radiological findings increased with the increase of duration of HD.
In addition, 18 patients had normal bone mineral density values, 18 patients had osteopenia, whereas 14 patients had osteoporosis.
Conclusion The increased duration of dialysis is associated with increased incidence of articular and skeletal complications mainly renal osteodystrophy in the form of crystal-induced arthritis, osteoporosis, and periarticular calcification.
Knee and shoulder joints, spine, neck of femur, wrist joints, and ribs are the main targets for complications and then for proper prophylaxis.
نمط استشهاد جمعية علماء النفس الأمريكية (APA)
Abd al-Wahhab, Hisham E.& Abd al-Aziz, Tariq M.& al-Sayyad, Muhammad M.& Berengy, Mahmud S.. 2019. Articular and skeletal affection in regularly dialyzed patients with end-stage renal disease. Egyptian Rheumatology and Rehabilitation،Vol. 46, no. 3, pp.162-169.
https://search.emarefa.net/detail/BIM-893849
نمط استشهاد الجمعية الأمريكية للغات الحديثة (MLA)
Abd al-Wahhab, Hisham E.…[et al.]. Articular and skeletal affection in regularly dialyzed patients with end-stage renal disease. Egyptian Rheumatology and Rehabilitation Vol. 46, no. 3 (Jul. / Sep. 2019), pp.162-169.
https://search.emarefa.net/detail/BIM-893849
نمط استشهاد الجمعية الطبية الأمريكية (AMA)
Abd al-Wahhab, Hisham E.& Abd al-Aziz, Tariq M.& al-Sayyad, Muhammad M.& Berengy, Mahmud S.. Articular and skeletal affection in regularly dialyzed patients with end-stage renal disease. Egyptian Rheumatology and Rehabilitation. 2019. Vol. 46, no. 3, pp.162-169.
https://search.emarefa.net/detail/BIM-893849
نوع البيانات
مقالات
لغة النص
الإنجليزية
الملاحظات
Includes bibliographical references : p. 169
رقم السجل
BIM-893849
قاعدة معامل التأثير والاستشهادات المرجعية العربي "ارسيف Arcif"
أضخم قاعدة بيانات عربية للاستشهادات المرجعية للمجلات العلمية المحكمة الصادرة في العالم العربي
تقوم هذه الخدمة بالتحقق من التشابه أو الانتحال في الأبحاث والمقالات العلمية والأطروحات الجامعية والكتب والأبحاث باللغة العربية، وتحديد درجة التشابه أو أصالة الأعمال البحثية وحماية ملكيتها الفكرية. تعرف اكثر