| [ Summary ] |
Orthopaedic disorders in hemodialysis patients may be caused by both Chronic Kidney Disease-Mineral Bone Disorder (CKD-MBD) and musculoskeletal tissue disorders which amyloid (β2-microglobulin deposits) induce. CKD-MBD cause osteitis fibrosa in secondary hyperparathyroidism and aplastic bone resulting in fragility of bodywide bone. Amyloid deposits cause inflammatory, proliferative and destructive changes in all musuculoskeletal tissues, including pinal canal stenosis, joint and spine destruction resulting in spinal canal stenosis, arthropathy and destructive spondyloarthropathy (DSA). Quality of life (QOL) becomes seriously impaired in patients with arthropathy or DSA. Additionally the number of elderly persons with diabetic and/or arterial nephrosclerosis requiring dialysis has increased. For orthopaedic patients with serious arthropathy and/or DSA we should perform surgery as well as appropriate perioperative management. |