title: Destructive Spondyloarthropathy in Patients on Long-Term Peritoneal Dialysis or Hemodialysis.
abstract: Destructive spondyloarthropathy (DSA) is the most serious spinal complication of dialysis-related amyloidosis in patients on long-term hemodialysis (HD), but we could not find any information about DSA in patients on peritoneal dialysis (PD) for over 10 years. We retrospectively evaluated factors contributing to DSA in HD and PD patients. Sixty-seven patients on dialysis for 10 to 19 years were compared between a PD group (n = 23) or a HD group (n = 44). In the PD group, nine patients (39%) developed DSA. The mean age of DSA patients was significantly higher than that of non-DSA patients (66.2 ± 10.0 vs. 51.0 ± 12.8 years, P = 0.03). The frequency of cervical spine DSA did not show any difference between the PD and HD groups, but the frequency of lumbar spine DSA showed a significant difference (22% vs. 5%, P = 0.04). The serum beta-2 microglobulin (B2MG) level was significantly higher in PD patients than in HD patients (38.4 mg/L vs. 27.4 mg/L, P = 0.0025). Mechanical stress such as elevation of the intra-abdominal pressure due to infusion of PD fluid (1500 mL to 2000 mL) for over 10 years might contribute to lumbar DSA in patients on long-term PD.
authors: Department of Nephrology, Toranomon Hospital, Tokyo, Japan.
authors: Noriko
authors: N
authors: Hayami
authors: Department of Nephrology, Toranomon Hospital, Tokyo, Japan.
authors: Junichi
authors: J
authors: Hoshino
authors: Department of Nephrology, Toranomon Hospital, Tokyo, Japan.
authors: Tastuya
authors: T
authors: Suwabe
authors: Department of Nephrology, Toranomon Hospital, Tokyo, Japan.
authors: Keiichi
authors: K
authors: Sumida
authors: Department of Nephrology, Toranomon Hospital, Tokyo, Japan.
authors: Koki
authors: K
authors: Mise
authors: Department of Nephrology, Toranomon Hospital, Tokyo, Japan.
authors: Satoshi
authors: S
authors: Hamanoue
authors: Department of Nephrology, Toranomon Hospital, Tokyo, Japan.
authors: Naoki
authors: N
authors: Sawa
authors: Department of Orthopedics, Toranomon Hospital, Tokyo, Japan.
authors: Izuru
authors: I
authors: Kitajima
authors: Department of Orthopedics, Toranomon Hospital, Tokyo, Japan.
authors: Yutaka
authors: Y
authors: Hirota
authors: Department of Pathology, Toranomon Hospital, Tokyo, Japan.
authors: Kenichi
authors: K
authors: Oohashi
authors: Department of Pathology, Toranomon Hospital, Tokyo, Japan.
authors: Takeshi
authors: T
authors: Fujii
authors: International University of Health and Welfare Mita Hospital, Tokyo, Japan.
authors: Itsuko
authors: I
authors: Okuda
authors: Department of Nephrology, Toranomon Hospital, Tokyo, Japan.|Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan.
authors: Kenmei
authors: K
authors: Takaichi
authors: Department of Nephrology, Toranomon Hospital, Tokyo, Japan.|Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Tokyo, Japan.
authors: Yoshifumi
authors: Y
authors: Ubara
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000686:Amyloidosis / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D059325:Intra-Abdominal Hypertension / Q000453:epidemiology / Q000209:etiology; D007564:Japan / Q000453:epidemiology; D000069451:Long Term Adverse Effects; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010530:Peritoneal Dialysis / Q000009:adverse effects / Q000379:methods; D011859:Radiography; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D025242:Spondylarthropathies / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D016896:Treatment Outcome; D001613:beta 2-Microglobulin / Q000097:blood*
chemical_list: D001613:beta 2-Microglobulin
keywords: Destructive spondyloarthropathy; Dialysis-related amyloidosis; Hemodialysis; Peritoneal dialysis