The Japanese Journal of Clinical Dialysis Vol.14 No.1(2)

Theme Destructive Spondyloarthropathy in Long-term Hemodialysis Patients
Title Epidemiological study of the destructive spondyloarthropathy
Publish Date 1998/01
Author Tatsuya Miyamoto Department of Orthopedic Surgery, Kyoto First Red Cross Hospital
[ Summary ] An epidemiological study of destructive spondyloarthropathy (DSA) in hemodialyzed patients was performed. Of the total of 591 patients, 98 (16.6%) were diagnosed as having DSA and the rate rose with increasingly long-term hemodialysis. In younger patients without disc lesions the onset of DSA is 10 to 15 years after starting hemodialysis. Therefore, among older patients with degenerative changes, some cases are apparent within about 5 years. It is important to not overlook erosion at the anterior enthesoperidiscal region, which is an initial finding of DSA, and to recognize individual instability of the time at beginning hemodialysis. Furthermore, it is of importance to observe the difference around the disc space by using periodic radiological investigation. DSA is anticipated with discitis causing increased instability of the spine with amyloid deposition. This type of DSA has an acute onset, and with the aging of hemodialyzed patients, is expected to become more frequent.
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