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AB1336 Musculoskeletal disorders in hemodialysis patients: different disease clustering according to age and dialysis vintage

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Background The number of patients suffering from stage 5 Chronic Kidney Disease is constantly increasing and their life expectancy has improved due to the hemodialysis technique. Musculoskeletal disorders remain a… Click to show full abstract

Background The number of patients suffering from stage 5 Chronic Kidney Disease is constantly increasing and their life expectancy has improved due to the hemodialysis technique. Musculoskeletal disorders remain a major problem in long term hemodialysis patients. Frequency and severity of these manifestations increase with the length of the dialysis. Objectives To identify diseases clustering profiles of musculoskeletal disorders in hemodialysis patients. Methods All adult patients in the hemodialysis centre were included in this cross-sectional study. For each patient, we filled a data collection sheet including basic demographic characteristics, musculoskeletal symptoms, biologic parameters and treatments. Musculoskeletal disorders were classified by a rheumatologist into pre-defined diagnostic categories: Osteoarthritis, Fractures, Tendinopathies, Carpal Tunnel Syndrome, Crystal deposition disease and Others. Prevalences were presented and a cluster analysis was performed. Results Eighty-nine patients were included (table 1). Mean age was 67.5±12 years. 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 disorders were osteoarthritis (53.9%), fracture (27%), tendinopathy (22.5%), carpal tunnel syndrome (18%), and chondrocalcinosis (9%). Musculoskeletal symptoms were significantly related to the dialysis vintage and age (p=0.044, p=0.035 respectively). All disorders categories were significantly associated with dialysis vintage, particularly increasing after the seventh year of dialysis. Cluster analysis identified three patient profiles: younger with low calcium levels, younger but long dialysis vintage with osteoarthritis and carpal tunnel syndrome, older and long dialysis vintage with fractures (figure 1).Abstract AB1336 – Table 1 Population characteristics N 89 Age (years±SD) 67.5±12.6 Sex ratio (M/F) 49/39 Age at the start of hemodialysis year(±SD) 61.5±14.6 Dialysis vintage (years±SD) 5.7±5.37 Diagnostic nephropathy Diabetes 27 (30.3%) Hypertension 26 (29.2%) Chronic glomerulonephritis 13 (14.6%) Polycystic kidney disease 10 (11.2%) Chronic interstitial nephropathy 7 (7.9%) Others 6 (6.7%)Abstract AB1336 – Figure 1 Conclusions The prevalence of the musculoskeletal manifestations is high (76.4%) in the hemodialysis population. Musculoskeletal disorders seem to cluster differently according to age and dialysis vintage. Acknowledgements Dr Ghada Abi Karam and Dr Fouad Fayad. Disclosure of Interest None declared

Keywords: dialysis vintage; age; disease; musculoskeletal disorders; dialysis

Journal Title: Annals of the Rheumatic Diseases
Year Published: 2018

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