Destructive spondyloarthropathy in hemodialysis patients: comparison between patients with and those without destructive spondyloarthropathy.

OBJECTIVE

Destructive spondyloarthropathy (DSA) is a serious complication of hemodialysis. The authors' objective was to define the incidence of DSA at their hospital and to search for risk factors for DSA.

METHODS

The authors examined 616 patients undergoing hemodialysis. Patients were separated into two groups: those with DSA and those without DSA when hemodialysis was begun. Other variables explored were the etiology of renal failure, total duration of hemodialysis, documentation of osteoporosis (including bone mineral density and serum beta2-microglobulin level), the spinal location of DSA lesions, and the presence of amyloidosis outside the spine.

RESULTS

DSA lesions were detected in 123 patients (20.0%). The mean period of hemodialysis was statistically longer in patients with DSA. Statistically, the incidence of osteoporosis was higher and bone mineral density was lower in the patients with DSA.

CONCLUSION

On multivariate analysis, risk factors for DSA were found to be the patient's age at the start of hemodialysis and the duration of hemodialysis.