Couto Cláudio I, Natour Jamil, Carvalho Aluízio B
Division of Nephrology, Federal University of São Paulo, São Paulo, Brazil.
Hemodial Int. 2008 Jan;12(1):66-72. doi: 10.1111/j.1542-4758.2008.00243.x.
Fibromyalgia syndrome (FMS) is characterized by widespread musculoskeletal pain. It has negative effects on quality of life and has been poorly investigated in specific populations. Our aim was to determine the prevalence of FMS in Brazilian hemodialysis (HD) patients and to investigate its effects on the quality of life. We investigated 311 patients on HD who were submitted to physical examination towards the classification of FMS. All subjects from FMS and control groups were submitted to laboratorial investigation and completed questionnaires of quality of life. The prevalence of FMS was 3.9%, which was close to that of the general population. Most patients were females and from non-Caucasian races. No difference between FMS and control groups was observed regarding race, dialysis adequacy, nutritional status and level of schooling. Ionized calcium was higher in the FMS group than in the control group. There was no association between FMS and secondary hyperparathyroidism. On the other hand, FMS was associated with worse quality of life, depression and anxiety. In conclusion, the prevalence of FMS in HD patients was similar to that of the general population. It was associated with decreasing quality of life in HD patients, in addition to higher degrees of depression and anxiety. No laboratory tests could identify FMS patients on HD. Fibromyalgia syndrome subsequently follows without a well-established mechanism of pathogenesis, and seems to be due to multifactorial causes. Its true impact on the quality of life of HD patients deserves more attention by nephrologists.
纤维肌痛综合征(FMS)的特征是广泛的肌肉骨骼疼痛。它对生活质量有负面影响,并且在特定人群中的研究较少。我们的目的是确定巴西血液透析(HD)患者中FMS的患病率,并研究其对生活质量的影响。我们调查了311名接受HD治疗的患者,对其进行了体格检查以进行FMS分类。FMS组和对照组的所有受试者均接受了实验室检查并完成了生活质量问卷。FMS的患病率为3.9%,与普通人群相近。大多数患者为女性且来自非白种人种族。在种族、透析充分性、营养状况和受教育程度方面,FMS组和对照组之间未观察到差异。FMS组的离子钙高于对照组。FMS与继发性甲状旁腺功能亢进之间无关联。另一方面,FMS与较差的生活质量、抑郁和焦虑相关。总之,HD患者中FMS的患病率与普通人群相似。它与HD患者生活质量下降相关,此外还与更高程度的抑郁和焦虑有关。没有实验室检查能够识别HD患者中的FMS患者。纤维肌痛综合征随后发病,其发病机制尚未完全明确,似乎是由多因素引起的。它对HD患者生活质量的真正影响值得肾病学家更多关注。