Spontaneous Bilateral Rupture of the Achilles Tendons in a Renal Transplant Recipient

Magnetic resonance imaging may be an asset to diagnose and classify fluoroquinolone‐associated Achilles tendinitis

“…An additional interesting finding is that in the majority of our patients there was clinical or biological evidence of active renal disease at the time of assessment; and fluoroquinolones are widely prescribed in this selected patient population. It is well known that spontaneous rupture, a classic but rare complication of renal disease, is probably due to an accelerated degeneration of collagen fibers associated with hyperparathyroidism and long-term steroid therapy (Hestin et al, 1993). As the Achilles tendon is the more mechanically hard worked region of the ankle, fluoroquinolones may act as an additional risk factor for rupture .…”

Incidence, Risk Factors, and Treatment of Achilles Tendon Rupture in Patients With End-Stage Renal Disease

“…An association between kidney disease and spontaneous ATR has been documented in many case reports. 3,4,11,17,32 Corticosteroid and fluoroquinolone use are known risk factors for tendon rupture, and both of these medications are commonly prescribed for patients with kidney disease or after a kidney transplant. 5,30 In addition, chronic kidney disease and maintenance dialysis create multiple metabolic abnormalities, particularly hyperparathyroidism, that appear to increase the risk for tendon rupture.…”

Bilateral Simultaneous Achilles Tendon Rupture in the Absence of Risk Factors

“…13 Achilles tendon rupture is a well-known complication of renal transplantation. 14 In patients undergoing hemodialysis, rupture may be related to the duration of dialysis and the severity of secondary hyperparathyroidism. 15 Systemic condition causing dehydration and decreased tendon blood flow can lead to hypoxia and impaired metabolic activity in a degenerate tendon, 16 predisposing it to injury.…”