Spondylodiscitis in Patients under Haemodyalisis

Öz

Objective: In addition to causing immunosuppression, hemodialysis may increase the risk of infection, given that the patients are more frequently exposed to vascular interventions and operative procedures. The present study aims to reveal the prevalence of spondylodiscitis in patients on hemodialysis, potential factors, and parameters that may help in the early diagnosis of the disease.
Materials and Methods: Patients who received treatment in the hemodialysis unit between 2010 and 2020 were included in the present study. Data of patients with low back pain were obtained retrospectively from the Mia-Med patient registry system.
Results: The frequency of spondylodiscitis was 2.3%. Findings showed that the prolonged dialysis duration (p<0.001), catheter use (p=0.005), diabetes mellitus (p=0.029), and heart failure (p=0.005) increased the risk of discitis. Leukocyte (p<0.001), neutrophil-to-lymphocyte ratio (NLR) (p=0.006), platelet-to-lymphocyte ratio (PLR) (p=0.001), sedimentation (p<0.001) and C-reactive protein (CRP) (p<0.001) levels were significantly higher in patients with spondylodiscitis.
Conclusion: Spondylodiscitis occurs more prevalently in patients with comorbidity, have long hemodialysis duration, use catheters and in elderly patients. Leukocytosis, CRP, sedimentation can be used for rapid diagnosis. In addition, NLR and TLR, which can be easily calculated from the results of whole blood tests, are parameters that can be used in diagnosis.

Anahtar Kelimeler

• Hematological parameters
• Hemodialysis
• Spondylodiscitis

Hemodiyaliz Hastalarinda Spondilodiskitis

Öz

Amaç: Hemodiyaliz immünsupresyon yaratmasının yanı sıra hastaların damar girişimlerine ve operatif prosedürlere daha sık maruz kalmaları nedeniyle enfeksiyon riskini arttırmaktadır. Amacımız hemodiyaliz hastalarında spondilodiskitis oranını, olası etkenleri ve hastalığa erken tanı konmasına yardımcı olabilecek parametreleri ortaya koymaktır.
Materyal ve Metot: 2010-2020 tarihleri arasında hemodiyaliz ünitesinde tedavi alan hastalar çalışmaya dahil edildi. Bel ağrısı şikayeti olan hastaların verilerine Mia-Med hasta kayıt sisteminden retrospektif olarak ulaşıldı.
Bulgular: Spondilodiskitis sıklığı %2,3 idi. Diyaliz süresinin uzaması (p<0,001), kateter kullanımı (p=0,005), diabetes mellitus (p=0,029) ve kalp yetmezliği (p=0,005) varlığının diskitis riskini arttırdığı saptandı. Spondilodiskitis bulunanlarda lökosit (p<0,001), nötrofil lenfosit oranı (NLO) (p=0,006), trombosit lenfosit oranı (TLO) (p=0,001), sedimentasyon (p<0,001) ve C- reaktif protein (CRP) (p<0,001) değerleri anlamlı olarak yüksek idi.
Sonuç: Spondilodiskitis komorbiditesi olan, hemodiyaliz süresi uzun, kateter kullanılan ve ileri yaştaki hastalarda daha sık ortaya çıkmaktadır. Hızlı tanı için lökositoz, CRP, sedimantasyon gibi tetkikler kullanılabilir. Ayrıca tam kan tetkik sonuçlarından kolaylıkla hesaplanabilen NLR ve TLR, tanıda kullanılabilecek parametrelerdir. 

Anahtar Kelimeler

• Hematolojik parametreler
• Hemodiyaliz
• Spondilodiskitis

Kaynakça

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