Pathological damage of bones and joints in patients on hemodialysis in Saint Petersburg

Abstract

BACKGROUND. The number of patients with end-stage renal disease is steadily increasing. One of the main complications arising from the disorders of calcium-phosphorus metabolism in patients on hemodialysis is various types of renal osteodystrophy. The frequency of pathological fractures among patients receiving renal replacement therapy is twice as high as in the general population. The prevalence and structure of injuries, especially the diagnosis of injuries of the musculoskeletal system in hemodialysis patients, are not well understood. THE AIM: to determine the prevalence and structure of injuries and the consequences of pathological injuries of bones and joints undergoing hemodialysis in Saint-Petersburg. To achieve this goal, the authors developed a special questionnaire, consisting of 4 blocks, including 32 questions.PATIENTS AND METHODS. An analysis of questionnaires of 798 patients from 15 hemodialysis centers of Saint-Petersburg was carried out.RESULTS. A number of problems were identified, such as insufficient coverage of patients not only with specific instrumental examination methods (MSCT, MRI), but also with radiographic ones. Satisfaction with quality of life and physical activity was noted in less than half of patients. 46.4% had a history of fractures and injuries, while the proportion of operated patients was half that, which indicates the need for more active work of hemodialysis centers with city hospitals with traumatology and orthopedic departments.CONCLUSION. Patients on HD require regular x-ray examination and densitometry to detect pathological damage to bones and joints. Based on the results of these studies, it is advisable to consult a traumatologist at least 1 time per year.