Multicentre cross‐sectional study for bone‐articular lesions associated with dialysis related amyloidosis in Japan

• Published in: Nephrology (Carlton, Vic.) Vic.), 2018-07, Vol.23 (7), p.640-645
• Main Authors: Nishi, Shinichi, Hoshino, Junichi, Yamamoto, Suguru, Goto, Shunsuke, Fujii, Hideki, Ubara, Yoshifumi, Motomiya, Yoshihiro, Morita, Hiroyuki, Takaichi, Kenmei, Yamagata, Kunihiro, Shigematsu, Takashi, Ueda, Mitsuharu, Ando, Yukio
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Aged; Amyloidosis; Amyloidosis - diagnosis; Amyloidosis - epidemiology; Amyloidosis - physiopathology; Carpal tunnel syndrome; Carpal Tunnel Syndrome - epidemiology; Carpal Tunnel Syndrome - physiopathology; Cross-Sectional Studies; Cysts; destructive spondyloarthropathy; Dialysis; Female; Hemodialysis; Humans; Incidence; Japan; joint pain; Knee; Knee Joint - physiopathology; Male; Middle Aged; Multiple regression analysis; Musculoskeletal Diseases - diagnosis; Musculoskeletal Diseases - epidemiology; Musculoskeletal Diseases - physiopathology; Pain; Prognosis; Renal Dialysis - adverse effects; Retrospective Studies; Risk Factors; Shoulder Pain - epidemiology; Shoulder Pain - physiopathology; spinal canal stenosis; Spondyloarthropathy; Stenosis; Time Factors; trigger finger; Trigger Finger Disorder - epidemiology; Trigger Finger Disorder - physiopathology; Walking
• ISSN: 1320-5358; 1440-1797
• DOI: 10.1111/nep.13077

Aim Dialysis‐related amyloidosis (DRA) exhibits multiple bone‐articular lesions, such as carpal tunnel syndrome (CTS), trigger finger (TF), spinal canal stenosis (SCS), destructive spondyloarthropathy (DSA), bone cysts, and joint pains. DRA leads to a decrease in activities of daily living (ADL). We investigated the initiation of CTS and TF, and evaluated the relationship between walking disturbances and bone‐articular lesions or joint pains. Methods A multicentre cross‐sectional study was performed. Eighty‐two patients with clinical DRA from 20 hospitals in Japan were evaluated. Results Of the 82 patients, the first symptom of DRA was CTS in 39 patients (47.6%) and TF in 21 (25.6%). The mean new‐onset vintages of 21 earlier cases in the CTS and TF groups were 86.1 ± 36.3 and 133.2 ± 56.4 (mean ± SD) months, respectively (P = 0.0091). The development of SCS and DSA appeared to be later than CTS and TF. Multiple regression analysis revealed that knee joint pain was a significant contributor to walking disturbances. Conclusion Carpal tunnel syndrome appeared significantly earlier than TF since the initiation of dialysis. In the advanced phase, knee joint pain was a major cause of decreased ADL in patients with clinical DRA. Summary at a Glance A multicentre cross‐sectional study regarding dialysis related amyloidosis (DRA) was performed in Japan. The incidence of carpal tunnel syndrome was earlier compared to trigger finger. The mean lag time was about 50 months. Shoulder and knee joint pains were significant contributors for walking disturbance in the patients with DRA.