Abstract

Abstract BACKGROUND AND AIMS Patients with end-stage kidney disease (ESKD) on regular hemodialysis (HD) suffer from a high burden of comorbidities. Musculoskeletal disorders (MSDs) are frequently encountered in those patients. The factors linked to MSDs in HD patients are incompletely defined, therefore this study was done to figure out how often musculoskeletal symptoms are in those patients and identify their association with many psychosocial aspects including quality of sleep, social support and fatigue. METHOD This cross-sectional study was carried out in the HD unit at Mansoura University Hospital, Egypt in the period from August to December 2021. The sample included 94 ESRD patients on regular HD for more than 3 months. Sociodemographic characteristics, clinical and therapeutic data were collected. The Nordic Musculoskeletal Questionnaire (NMQ-E) was used to determine the prevalence and patterns of MSDs in various parts of the body areas. Moreover, the modified Edmonton Symptom Assessment System, multidimensional Fatigue Inventory (MFI-20), Pittsburgh Sleep Quality Index (PSQI), Perceived Social Support from Family Scales were completed by the patients. MSDs predictors were evaluated by univariate regression analysis. RESULTS The mean age of the studied patients was 49.73 years and more than half of them (59.6%) were males. MSDs affected nearly three quarters (72.3%) of patients. The most frequently encountered MSD domains were knee pain (48.9%), low back pain (43.6%), shoulder pain (41.6%), hip/thigh pain (35.1%) and neck pain (35.1%) (Figure 1). Regarding Pain and symptom burden, patients with MSDs had significantly higher scores of pain (P < 0.001), fatigue (P = 0.01), depression (P = 0.015) and anxiety (P = 0.003). Regarding MFI scale, patients with MSDs experienced reduced activity (P = 0.02). Subjective sleep quality, daytime dysfunction domains and global PSQI score were worse among patients with MSDs (P = 0.02, 0.031 and 0.036, respectively). Patients with MSDs perceived less social support (P = 0.029). Female gender (P = 0.013), higher scores of fatigue (P = 0.012), depression (P = 0.014), anxiety (P = 0.004), reduced activity (P = 0.029) domains and PSQI score (0.027) were the significant predictors of MSDs in the studied HD patients (Table 1). CONCLUSION MSDs appears to frequently occur in HD patients. Female gender, fatigue, depression, anxiety, reduced activity and poor sleep quality can predict the occurrence of MSDs in HD patients.

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