Open AccessArm disability in patients on hemodialysis
Author(s) -
Toffola Elena Dalla,
Petrucci Lucia,
Mazzacane Bruno,
Klersy Catherine,
Villa Giuseppe,
Bossi Daniela,
Bejor Maurizio
Publication year - 2010
Publication title -
dialysis & transplantation
Language(s) - English
Resource type - Journals
eISSN - 1932-6920
pISSN - 0090-2934
DOI - 10.1002/dat.20418
Subject(s) - medicine , dash , interquartile range , hemodialysis , dialysis , upper limb , physical therapy , population , kidney disease , surgery , environmental health , computer science , operating system
End‐stage renal disease patients on hemodialysis (HD) often present osteoarticular and musculoskeletal complications related both to chronic renal disease as well as to chronic dialysis. The aim of the present study was to assess the degree of upper‐limb disability, and its determinants, in a group of patients on chronic HD to determine functional capacity and the need for rehabilitative treatment. MATERIALS AND METHODS We studied 97 HD patients (46 male, 51 female) with a mean age of 64.4 years, and 51 healthy controls. The Disabilities of the Arm, Shoulder, and Hand (DASH) Outcome Measure was used to clinically assess degree of disability as well as finger function and movement. RESULTS For study purposes, patients were divided into 3 groups according to the duration of dialysis: <5 years, 5–10 years, and >10 years. The median DASH score was 9.5 (interquartile range [IQR]: 3.4–24.1) in the entire population. However, it differed significantly in the 3 dialysis groups with scores of 5.2 (IQR: 2.6–18.1), 14.7 (3.4–23.7), and 37.5 (9.5–73.3) in the <5 year, 5–10 year, and >10 year groups, respectively ( p < .001). Additionally, disability correlated with shoulder and hand pain and with finger stiffness. Moreover, patients on dialysis for more than 10 years were affected by pain involving several upper limb joints. All patients who worked had a DASH score lower than 20. The median DASH score was 2.6 (IQR: 0.9–5.2) in the control group. CONCLUSION Duration of dialysis is associated with progressive disability. Thus, early rehabilitation programs are recommended in patients who are expected to undergo long‐term dialysis.