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Musculoskeletal disorders in hemodialysis patients: different disease clustering according to age and dialysis vintage

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Abstract

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.

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Fig. 1
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Abbreviations

CKD:

Chronic kidney disease

HPT:

Secondary hyperparathyroidism

IU:

International unit

CTS:

Carpal tunnel syndrome

CKD-MBD:

Chronic kidney disease-mineral and bone disorders

BMD:

Bone mineral density

FGF23:

Fibroblast growth factor 23

CaxP:

Calcium phosphate product

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Acknowledgments

The authors would like to thank Dr. Ghada Abi Karam and Dr. Fouad Fayad for providing access to their respective rheumatology files.

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Authors and Affiliations

  1. Saint-Joseph University, Beirut, Lebanon

    Sandrine Hage

  2. Division of Nephrology, Centre Hospitalier de Bhannes, Mount Lebanon, Nephrology Department, Hotel-Dieu de France Hospital, Saint-Joseph University, Beirut, Lebanon

    Valérie Hage

  3. Rheumatology Department, Hotel-Dieu de France Hospital, Saint-Joseph University, Beirut, Lebanon

    Nathalie el-Khoury & Nelly Ziadé

  4. Nephrology Department, Hotel-Dieu de France Hospital, Saint-Joseph University, Beirut, Lebanon

    Hiba Azar & Dania Chelala

Authors
  1. Sandrine Hage
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  2. Valérie Hage
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  3. Nathalie el-Khoury
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  4. Hiba Azar
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  5. Dania Chelala
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  6. Nelly Ziadé
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Contributions

NZ designed the study. HA and DC provided expertise and approval to include the patients. SH and NK conducted the study and collected the data. NZ analyzed and interpreted the data. VH drafted the manuscript. NZ, HA, and DC critically reviewed the manuscript.

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Correspondence to Valérie Hage.

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Hage, S., Hage, V., el-Khoury, N. et al. Musculoskeletal disorders in hemodialysis patients: different disease clustering according to age and dialysis vintage. Clin Rheumatol 39, 533–539 (2020). https://doi.org/10.1007/s10067-019-04786-w

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  • DOI: https://doi.org/10.1007/s10067-019-04786-w

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