Spontaneous Tendon Ruptures in Patients with End-Stage Renal Disease

Abstract

Spontaneous tendon ruptures in patients with end-stage renal disease (ESRD) have been occasionally reported. We describe the largest group of patients with spontaneous rupture of major tendons so far reported. Rupture of 16 tendons occurred in 9 patients. The mean patient age was 52.78 years; 77.7% were male. Four patients were treated with hemodialysis, 4 received a renal transplant and 1 was treated with automated peritoneal dialysis. Bilateral rupture was found in 5 patients (3 quadriceps, 1 Achilles and 1 supraspinatus and subscapularis tendon rupture). Distal brachial biceps tendon rupture, Achilles tendon rupture, unilateral quadriceps and rupture of the oblique internal abdominal muscle tendon were developed by 1 patient each. Patients were treated with renal replacement therapy for 3–21 years (mean 12.89). Five patients were treated with steroids and 6 patients received quinolone antibiotic before the tendon rupture. All patients had laboratory and clinical signs of hyperparathyroidism. A patient who was treated with automated peritoneal dialysis for 3 years had primary hyperparathyroidism with nephrolithiasis as the cause of ESRD. Our results demonstrated that patients with hyperparathyroidism are at increased risk for development of spontaneous tendon ruptures, and the risk is further amplified when they receive quinolone antibiotics and/or steroids.

Percutaneous, Minimally Invasive Repair of Traumatic and Simultaneous Rupture of Both Achilles Tendons: A Case Report

“…Typically, bilateral damage occurs spontaneously in patients taking glucocorticoids. Other risk factors include the use of fluoroquinolones, rheumatic diseases, endocrine and metabolic disorders, and prolonged hemodialysis (3)(4)(5). Bilateral traumatic damage to the Achilles tendon is rare (1,4).…”

“…Bilateral Achilles tendon injuries are a rare and usually result from a nontraumatic injury (1)(2)(3)(4)(5). In the present report, we describe a simple and effective surgical and rehabilitation protocol used to treat an adult male who had experienced bilateral, traumatic, total rupture of the Achilles tendon of each lower extremity.…”

Die spontane Achillessehnenruptur – ein vorhersehbares Ereignis?

“…Glycyrrhizae Radix 3g ten beobachtet werden. Der genaue Pathomechanismus ist jedoch noch nicht geklärt [11,12]. Der Spieler Beckham hatte englischen Tageszeitungen gestanden, Angst davor zu haben "es nicht zu schaffen".…”

Geovariation in Fracture Risk among Patients Receiving Hemodialysis

“…Such derangements also likely contribute to tendon ruptures, which are relatively rare but serious events in patients on dialysis (14,15). Derangements include abnormalities directly linked with the mineral bone disorder of CKD, those associated with CKD (such as poor muscle strength or disturbances in body balance), the risk of orthostasis associated with large ultrafiltration volumes, and general risk factors (such as diabetes and osteoporosis) (1,2,16).…”