Tendon thickening in dialysis-related joint arthritis is due to amyloid deposits at the surface of the tendon

Sigaux, Johanna; Abdelkefi, Istabrak; Bardin, Thomas; Laredo, Jean‐Denis; Ea, Hang‐Korng; Ureña-Torres, Pablo; Cohen‐Solal, Martine

doi:10.1016/j.jbspin.2018.08.005

Cited by 11 publications

(12 citation statements)

References 28 publications

(34 reference statements)

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“…In addition, there are many other hypotheses about the etiology of tendinopathy in ESKD and dialysis patients. For example, some studies suggested that β2-microglobulin introduced amyloidosis in the tendon of dialysis patients may be the cause of tendon thickening and other symptoms of nerve damage [31][32][33]. Our results revealed that the tendon thickness in ESKD patients tends to be higher than in normal people; however, the observed difference was not statistically different, which may be partly due to the insufficient number of cases in our groups, and partly due to the possible differences in the degree of systemic tendon amyloidosis.…”

Section: Discussionmentioning

confidence: 99%

Quantitative evaluation of the Achilles tendon and supraspinatus tendon in end‐stage kidney disease patients: A potential tool for predicting spontaneous tendon rupture

et al. 2021

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Many cases of spontaneous tendon rupture in end‐stage kidney disease (ESKD) patients have been reported worldwide. Quantitative assessment of tendon has become an important way to improve the prognosis of patients. In the recruited healthy volunteers and ESKD patients, the thickness and shear wave velocity (SWV) of supraspinatus tendons and Achilles tendons were measured and compared among groups. Potential factors related to the tendon SWV of ESKD patients were screened in multiple linear regression. There was no significant difference in the tendon thickness and supraspinatus tendon SWV among groups. SWV of Achilles tendons in long‐term dialysis ESKD patients were significantly lower than those in healthy volunteers (5.1 vs. 5.6 m/s, p < 0.01). Ca2+, creatinine, body mass index, and genders are the significant factors related to the tendon SWV. Shear wave elastography can be used as a potential tool for predicting spontaneous tendon rupture in ESKD patients.

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Section: Discussionmentioning

confidence: 99%

Quantitative evaluation of the Achilles tendon and supraspinatus tendon in end‐stage kidney disease patients: A potential tool for predicting spontaneous tendon rupture

et al. 2021

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“…Thirdly, histologic confirmation of the deposits of Beta-2 microglobulin was available only in patients who underwent carpal tunnel or other surgeries, while in other cases, no morphologic confirmation, which could have been relevant in the early cases, was available. This limit is shared by virtually all the large studies on DRA, and is difficult to overcome as it involves subjecting patients undergoing dialysis, a time-consuming and intrusive treatment, to another invasive procedure, such as synovial biopsy [66,67,68]. This could be avoided if effective treatments were available, including anti-coiling agents, such as doxycycline, occasionally reported have good results in alleviating pain in DRA, or specific absorption columns, available in Japan, but not in Europe, partly on account of their high costs [69,70,71,72,73].…”

Section: Discussionmentioning

confidence: 99%

Positron Emission Tomography Can Support the Diagnosis of Dialysis-Related Amyloidosis

Santagati

Cataldo

Columbano

et al. 2019

JCM

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Background: The improvements in dialysis have not eliminated long-term problems, including dialysis-related amyloidosis (DRA), caused by Beta-2 microglobulin deposition. Several types of scintigraphy have been tested to detect DRA, none entered the clinical practice. Aim of the study was to assess the potential of PET-FDG scan in the diagnosis of DRA. Methods: Forty-six dialysis patients with at least one PET scan (72 scans) were selected out 162 patients treated in 2016–2018. Subjective global assessment (SGA), malnutrition inflammation score (A), Charlson Comorbidity Index (CCI), were assessed at time of scan; 218 age-matched cases with normal kidney function were selected as controls. PET scans were read in duplicate. Carpal tunnel syndrome was considered a proxy for DRA. A composite “amyloid score” score considered each dialysis year = 1 point; carpal tunnel-DRA = 5 points per site. Logistic regression, ROC curves and a prediction model were built. Results: The prevalence of positive PET was 43.5% in dialysis, 5% in controls (p < 0.0001). PET was positive in 14/15 (93.3%) scans in patients with carpal tunnel. PET sensitivity for detecting DRA was 95% (specificity 64%). Carpal tunnel was related to dialysis vintage and MIS. A positive PET scan was significantly associated with dialysis vintage, MIS and amyloid score. A prediction model to explain PET positivity combined clinical score and MIS, allowing for an AUC of 0.906 (CI: 0.813–0.962; p < 0.001). Conclusions: PET-FDG may identify DRA, and may be useful in detecting cases in which inflammation favours B2M deposition. This finding, needing large-scale confirmation, could open new perspectives in the study of DRA.

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“…Pain and limited range of motion of the knee joint were also observed in Cluster 1. Blood β2-microglobulin, a precursor protein of dialysis amyloidosis, is preferentially deposited in osteoarticular sites, and amyloid synovitis is present in various joints in patients undergoing long-term hemodialysis, with thickening of tendons and lesions of bone erosions [22]. Furthermore, hemodialysis itself is an inflammatory stimulus that induces cytokine production and complement activation [23].…”

Section: Basic Information and Physical Function Characteristics Of E...mentioning

confidence: 99%

Gait Classification and Physical Function Characteristics in Maintenance Hemodialysis Patients

T¹,

Hatanaka²

2022

saj

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Only walking velocity has been reported as a performance measure of gait in hemodialysis patients, and no kinematic or kinetic analysis has been reported. We evaluated basic information, physical function, aging, dialysis-related complications, and gait in 23 outpatients (≥60 years old) who could walk independently. Hierarchical cluster analysis was performed using joint angles, joint moments, and gait parameters during gait. The gait of hemodialysis patients was classified into two clusters: Cluster 1 and Cluster 2. Cluster 1 gait showed a longer hemodialysis duration, higher dialysis amyloidosis severity, knee joint pain, lower ankle plantarflexion weakness, and lower extremity joint dysfunction than Cluster 2. The gait of Cluster 1 patients consisted of flexion of the knee joint, ankle joint, and trunk, and excessive knee joint flexion was observed in the stance phase to escape posterior knee joint pain. Cluster 1 patients were also unable to kick out sufficiently, and their walking rate and walking velocity were decreased. Cluster 2 patients had a shorter hemodialysis duration than Cluster 1. External forces exerted on the knee joint in the hyperextension direction during gait could cause pain and inflammation of the posterior knee joint.

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Tendon thickening in dialysis-related joint arthritis is due to amyloid deposits at the surface of the tendon

Cited by 11 publications

References 28 publications

Quantitative evaluation of the Achilles tendon and supraspinatus tendon in end‐stage kidney disease patients: A potential tool for predicting spontaneous tendon rupture

Quantitative evaluation of the Achilles tendon and supraspinatus tendon in end‐stage kidney disease patients: A potential tool for predicting spontaneous tendon rupture

Positron Emission Tomography Can Support the Diagnosis of Dialysis-Related Amyloidosis

Gait Classification and Physical Function Characteristics in Maintenance Hemodialysis Patients

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