Hemodialysis is not essential for the development of destructive spondylarthropathy in patients with chronic renal failure.

Since 1984, there have been several reports of a destructive spondylarthropathy occurring in patients who have received hemodialysis over a long period of time. Two cases of a similar syndrome were observed in nonhemodialyzed patients with chronic renal failure, one of whom underwent a lumbar disc excision. The results of disc examination and of radiographic and biologic investigations prompted reconsideration of factors previously considered to be pathogenetic (amyloidosis, hydroxyapatite crystal deposition, aluminum toxicity), except one: secondary hyperparathyroidism.