Evaluation of relationship between symptoms and parameters in bones and joints in chronic hemodialysis patients

Abstract

Of 75 patients introduced to hemodialysis treatment at our institutes, correlation between incidence of symptoms such as bone or joint pain, and bone parameters was analyzed.
The incidence of these symptoms was 63%. The pain during movement of joints was 51%: knee joint pain 31%; shoulder joint pain 27%; hand-finger pain 15% and so on. The spontaneous skeletal pain was 21%-15% in upper extremities; 8% in lower extremities; 3% in lumbar and back area. The incidence increased throughout the duration of hemodialysis. Eighty two percent was recognized in females 40 to 50 years old.
These patients were separated into two groups according to the symptoms; symptom group (group A) and no symptom group (group B). The serum β₂-microgroburin level increased significantly in group A compared to group B. Levels of C-PTH, INS-PTH and osteocalcin were higher in group A than group B.
The incidence of symptoms was 50% in the normal grade of the microdensitometry method in metacarpal bone and 60% in the third grade. The MCI scores were positively correlated with the duration of hemodialysis in both groups and the ∑GS/D scores were also so correlated in group A. The ∑GS/D scores were significantly higher in the group with pain during movement of joints (group C) than the group with spontaneous pain (group D). The MCI scores and levels of serum Pi, C-PTH and INS-PTH were higher in group C than group D.
Based upon these observations, it is concluded that renal osteodystrophy due to moderate stage of hyperparathyroidism exists in groups A and C. It should be further analyzed whether spontaneous skeletal pain is related to osteomalacia due to aluminium intoxication.