Saint-Joseph University, Beirut, Lebanon.
Division of Nephrology, Centre Hospitalier de Bhannes, Mount Lebanon, Nephrology Department, Hotel-Dieu de France Hospital, Saint-Joseph University, Beirut, Lebanon.
Clin Rheumatol. 2020 Feb;39(2):533-539. doi: 10.1007/s10067-019-04786-w. Epub 2019 Nov 7.
Musculoskeletal disorders remain a major problem in hemodialysis patients. The aim of the study was to estimate the prevalence of musculoskeletal manifestations in hemodialysis patients and identify disease cluster profiles. We performed a cross-sectional study including all adult patients in the hemodialysis unit at Hotel-Dieu de France Hospital. We collected demographic characteristics, musculoskeletal symptoms, biologic parameters, and treatments. Musculoskeletal disorders were classified by a rheumatologist into predefined diagnostic categories. Prevalence was presented, and a cluster analysis was performed. Eighty-nine patients were included, mean age was 67.5 ± 12 years, and 43.8% were female. Dialysis vintage was 5.7 ± 5.37 years. Musculoskeletal symptoms were reported by 76.4% of the patients. Pain was the most frequent symptom (44.9%). The main diagnoses were osteoarthritis (53.9%) and fracture (27%). Musculoskeletal symptoms and disorders were significantly associated with dialysis vintage and age. Cluster analysis identified three patient profiles: younger with low calcium levels, younger but long dialysis vintage with osteoarthritis and carpal tunnel syndrome, and older with long dialysis vintage and fractures. The prevalence of musculoskeletal manifestations is high in the hemodialysis population and increases with dialysis vintage. Musculoskeletal disorders cluster according to age and dialysis vintage. Key Points• Musculoskeletal symptoms are highly prevalent among hemodialysis patients (76.4%).• All musculoskeletal disorders are associated with dialysis vintage and age.• Three clusters are identified among hemodialysis patients: young with low calcium levels, young but long dialysis vintage with osteoarthritis and carpal tunnel syndrome and old with long dialysis vintage with fractures.
肌肉骨骼疾病仍是血液透析患者的主要问题。本研究旨在评估血液透析患者肌肉骨骼表现的患病率,并确定疾病聚类特征。我们进行了一项横断面研究,纳入了法国医院 Hotel-Dieu 透析中心的所有成年患者。我们收集了人口统计学特征、肌肉骨骼症状、生物学参数和治疗情况。肌肉骨骼疾病由风湿病学家按照预先定义的诊断类别进行分类。我们呈现了患病率,并进行了聚类分析。共纳入 89 例患者,平均年龄为 67.5 ± 12 岁,43.8%为女性。透析龄为 5.7 ± 5.37 年。76.4%的患者报告有肌肉骨骼症状。疼痛是最常见的症状(44.9%)。主要诊断为骨关节炎(53.9%)和骨折(27%)。肌肉骨骼症状和疾病与透析龄和年龄显著相关。聚类分析确定了三种患者特征:钙水平低的年轻患者、钙水平低的年轻但透析龄长的患者,伴有关节炎和腕管综合征、钙水平低的年长患者且透析龄长的患者伴骨折。肌肉骨骼表现的患病率在血液透析人群中较高,且随透析龄增加而增加。肌肉骨骼疾病根据年龄和透析龄聚类。要点:• 肌肉骨骼症状在血液透析患者中高度普遍(76.4%)。• 所有肌肉骨骼疾病均与透析龄和年龄相关。• 在血液透析患者中确定了三个聚类:钙水平低的年轻患者、钙水平低的年轻但透析龄长的患者,伴有关节炎和腕管综合征、钙水平低的年长患者且透析龄长的患者伴骨折。