Çağlıyan Türk Ayla, Özkurt Sultan, Doğan İbrahim, Şahin Füsun
Department of Physical Medicine and Rehabilitation, Hitit University, Faculty of Medicine, Çorum, Turkey.
Department of Nephrology, Eskişehir Osmangazi University, Faculty of Medicine, Eskişehir, Turkey.
Arch Rheumatol. 2021 Oct 18;37(1):67-76. doi: 10.46497/ArchRheumatol.2022.8227. eCollection 2022 Mar.
This study aims to investigate the point prevalence of fibromyalgia in patients on hemodialysis and peritoneal dialysis and after renal transplantation compared to healthy controls and to evaluate depressive symptoms, anxiety level, and the impact of fibromyalgia on quality of life (QoL).
Between January 2018 and January 2019, a total of 107 hemodialysis patients (Group 1) (48 males, 59 females; median age: 50 years; range, 42 to 56 years), 51 peritoneal dialysis patients (Group 2) (32 males, 19 females; median age: 49 years; range, 39 to 54 years), 52 renal transplant patients (Group 3) (23 males, 29 females; median age: 45.5 years; range, 37 to 52 years), and 50 healthy controls (Group 4) (23 males, 27 females; median age: 46.5 years; range, 42 to 50 years) were included in the study. Age, sex, amount of time spent on dialysis, and laboratory data were recorded. Impact of fibromyalgia on QoL was evaluated using the Fibromyalgia Impact Questionnaire (FIQ), while depressive symptoms and anxiety level were assessed using the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI), respectively.
The point prevalence of fibromyalgia was 14% in Group 1 (n=15), 5.9% in Group 2 (n=3), 9.6% in Group 3 (n=5), and 4% in Group 4. There was a significant difference in the point prevalence of fibromyalgia between the hemodialysis group and healthy controls (p<0.05). The median FIQ scores were significantly higher in all patient groups than Group 4 (p<0.001); however, there was no significant difference between the patient groups (p>0.05). The median BDI scores were significantly higher in Group 1 and Group 2 than Group 4 (p<0.05). The median BAI scores were significantly higher in Group 1 than Group 4 (p<0.05). When the patients with and without fibromyalgia were compared, FIQ and BAI in Group 1, BAI in Group 2, and FIQ in Group 3 significantly differed (p<0.05). There was no relationship between fibromyalgia and any of the laboratory data, age, or time spent on dialysis (p>0.05).
Fibromyalgia is significantly more common among hemodialysis patients than healthy individuals with a similar prevalence to the healthy individuals for peritoneal dialysis and renal transplant patients. The presence of fibromyalgia is related to depressive symptoms, anxiety, and higher impact on QoL for patients with chronic kidney disease.
本研究旨在调查血液透析、腹膜透析患者及肾移植患者中纤维肌痛的点患病率,并与健康对照进行比较,同时评估抑郁症状、焦虑水平以及纤维肌痛对生活质量(QoL)的影响。
在2018年1月至2019年1月期间,共有107例血液透析患者(第1组)(48例男性,59例女性;中位年龄:50岁;范围42至56岁)、51例腹膜透析患者(第2组)(32例男性,19例女性;中位年龄:49岁;范围39至54岁)、52例肾移植患者(第3组)(23例男性,29例女性;中位年龄:45.5岁;范围37至52岁)和50例健康对照(第4组)(23例男性,27例女性;中位年龄:46.5岁;范围42至50岁)纳入本研究。记录年龄、性别、透析时间及实验室数据。使用纤维肌痛影响问卷(FIQ)评估纤维肌痛对生活质量的影响,同时分别使用贝克抑郁量表(BDI)和贝克焦虑量表(BAI)评估抑郁症状和焦虑水平。
第1组纤维肌痛的点患病率为14%(n = 15),第2组为5.9%(n = 3),第3组为9.6%(n = 5),第4组为4%。血液透析组与健康对照组之间纤维肌痛的点患病率存在显著差异(p < 0.05)。所有患者组的FIQ中位数得分均显著高于第4组(p < 0.001);然而,患者组之间无显著差异(p > 0.05)。第1组和第2组的BDI中位数得分显著高于第4组(p < 0.05)。第1组的BAI中位数得分显著高于第4组(p < 0.05)。比较有和没有纤维肌痛的患者时,第1组的FIQ和BAI、第2组的BAI以及第3组的FIQ存在显著差异(p < 0.05)。纤维肌痛与任何实验室数据、年龄或透析时间均无相关性(p > 0.05)。
纤维肌痛在血液透析患者中比健康个体更为常见,在腹膜透析和肾移植患者中的患病率与健康个体相似。纤维肌痛的存在与慢性肾病患者的抑郁症状、焦虑及对生活质量的更高影响有关。