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Renal Spondyloarthropathy



- See: Renal Osteodystrophy

- Discussion:
    - seen in hemodialysis patients with chronic renal failure and typically invovles three adjacent vertebrae with intervening discs;
    - changes include subluxation, degeneration, and narrowing of disc ht;
    - although the process may resemble infection, it probably represents crystal or amyloid deposition;
    - bone disease is a major complication of uremia and persists and sometimes worses even after the iniation of hemodialysis;
    - when bone disease becomes severe, spontaneous fractures may occur, esp in the ribs, pelvis, and hips;
    - uremic pts with advanced hyperparathyroidism appear prone to nontraumatic aseptic necrosis of the hips;
    - 20% of pts with renal osteodystrophy also show osteosclerosis, most frequently in the spine, but may also occur in long bones;
    - osteomalacia is commonly seen in patients on hemodyalysis therapy for chronic renal failure;
         - although it was originally presumed that the cause of this condition was an inability to for 1-25 Vit D does not usually correct this defect;
         - instead, the major cause of the osteomalacia is the intoxication of the skeleton with aluminum;
         - aluminum is presented to the body in form of aluminum containing phosphate binding antacids which are used to control phosphate accumulation in pts with renal failure


Pathological fractures in patients who have amyloidosis associated with dialysis. A report of five cases.

Destructive spondylo-arthropathy during long-term haemodialysis.

Tendinitis and tendon ruptures in successful renal transplant recipients.

Femoral neck fractures in patients receiving long-term dialysis.

Tendinitis--a common complication after renal transplantation.