Periton Diyalizi ve Hemodiyaliz Uygulanan Hastalarda Fibromiyalji Sendromu

Yıl 2018, Cilt: 8 Sayı: 3, 657 - 662, 30.09.2018

Gökhan Sargın , Taşkın Şentürk , Hakan Akdam

https://doi.org/10.31832/smj.421257

Öz

Amaç: Fibromiyalji sendromu (FMS) yorgunluk, hafıza
problemleri ve yaygın ağrı ile karakterizedir. Sendrom genel popülasyonun
yaklaşık % 2-8'inde bulunur. Bununla birlikte, konu ile ilgili belirli
popülasyonlardaki bilgiler sınırlıdır. Bizim amacımız, periton diyalizi,
hemodiyaliz hastalarında ve kontrol grubunda FMS, klinik ve laboratuvar
parametreleri arasındaki ilişkiyi değerlendirmektir.

Hastalar ve Yöntemler: Çalışmaya 89 diyaliz hastası ve sağlıklı gönüllü
dahil edildi. Kontrol grubu 30 sağlıklı yetişkin (9 kadın, 21 erkek, ortalama
yaş 52,9±16,3 yıl),  periton diyalizi
alan 21 hasta (7 kadın, 19 erkek, ortalama yaş 53±15,9 yıl), ve hemodiyaliz
alan 33 hasta (11 kadın, 22 erkek, yaş ortalaması 64,5±7,1 yıl) alındı.
Fibromiyalji 1990 American College of Rheumatology (ACR) kriterleri ve 2011
modifiye ACR preliminary tanı kriterlerinin ile konuldu. Cinsiyet, yaş,
böbrek fonksiyon testleri, elektrolitler, paratiroid hormon, böbrek yetmezlik etyolojisi
ve ne kadar süredir diyaliz yapıldığı kaydedildi.

Bulgular: Hemodiyaliz grubuna göre periton diyalizi alan hastalarda
fibromiyalji prevalansı daha fazlaydı. Periton diyaliz grubu ile sağlıklı grup
arasında istatistiksel olarak anlamlı bir fark yoktu. Ayrıca periton diyalizi
grubu ile sağlıklı grup arasında depresyon ve bilişsel işlevler arasında da istatistiksel
olarak anlamlı bir farklılık saptanmadı. Ancak, parametreler hemodiyaliz alan
hastalarda, periton dializ grubu ve sağlıklı gruba göre daha yüksek olarak
bulundu. Böbrek fonksiyon testleri ve elektrolit düzeyleri sağlıklı yetişkin ve
diyaliz grupları arasında anlamlı olarak farklıydı (p<0.001).

Sonuç: Fibromiyalji prevalansı, periton diyaliz grubu ve
sağlıklı grup arasında benzerdi. Bu durum, tedaviye aktif olarak katılma, daha
az stres faktörü ve böbrek fonksiyonlarının daha iyi korunması ile ilişkili
olabilir.

Anahtar Kelimeler: fibromiyalji sendromu, böbrek yetmezliği,
periton diyalizi, hemodiyaliz

Anahtar Kelimeler

fibromiyalji sendromu, böbrek yetmezliği, periton diyalizi

Fibromyalgia Syndrome in Patients Undergoing Peritoneal Dialysis and Hemodialysis

Öz

Objectives: Fibromyalgia syndrome (FMS) is characterized
by fatigue, memory problems, and widespread pain. The syndrome is present in
about %2-8 of the general population. However, knowledge about this topic in
specific populations is limited. Our aim was to evaluate FMS in patients undergoing peritoneal
dialysis, hemodialysis, and control group, and the association
between clinical
and laboratory parameters.

Patients
and Methods:
Eighty-nine dialysis patients and healthy volunteers were
included in the study. The control group compromised 30 healthy adults (9
females 21 males with mean age of 52,9±16,3 years), 26 patients (7 females 19
males, with mean age of 53±15,9 years) receiving peritoneal dialysis and 33
patients (11 females and 22 males, with mean age of 64,5±7,1 years) receiving hemodialysis were enrolled in this study.
Fibromyalgia was diagnosed with the criteria of 1990 American College of Rheumatology (ACR) and 2011
modification of the ACR preliminary diagnostic criteria. Gender, age, renal function tests, electrolytes, parathyroid
hormone, renal failure etiology, and how long has it been dialyzed were
recorded.  

Results: The prevalence of fibromyalgia was higher in patients with peritoneal
dialysis compared with hemodialysis group. There was no statistically
significant between peritoneal dialysis group and healthy group. Also, there
was no statistically significant between for depression and cognitive functions
between peritoneal dialysis group and healthy group. But, the parameter was
found to be high in patients receiving hemodialysis compared with peritoneal and
healthy groups. Kidney function tests and electrolyte levels were significantly
different between healthy adults and dialysis groups (p <0.001).

Conclusion: The prevalence of fibromyalgia was similar between
peritoneal dialysis and healthy group. It may be related to actively
participate in treatment, fewer stress factors, and better preservation of renal
functions.

Anahtar Kelimeler

fibromyalgia syndrome, renal failure, peritoneal dialysis

Kaynakça

• 1. Branco JC, Bannwarth B, Failde I, Abello Carbonell J, Blotman F, Spaeth M, et al. Prevalence of fibromyalgia: a survey in five European countries. Semin Arthritis Rheum. 2010;39:448-53.
• 2. Clauw DJ. Fibromyalgia: a clinical review. JAMA. 2014;311:1547-55.
• 3. Mas AJ, Carmona L, Valverde M, Ribas B; EPISER Study Group. Prevalence and impact of fibromyalgia on function and quality of life in individuals from the general population: results from a nationwide study in Spain. Clin Exp Rheumatol.2008;26:519-26.
• 4. Jahan F, Nanji K, Qidwai W, Qasim R. Fibromyalgia syndrome: an overview of pathophysiology, diagnosis and management. Oman Med J. 2012;27:192-5.
• 5. Metyas SK, Solyman JS, Arkfeld DG. Inflammatory Fibromyalgia: Is It Real? Curr Rheumatol Rev. 2015 May 21.
• 6. Haliloglu S, Carlioglu A, Akdeniz D, Karaaslan Y, Kosar A. Fibromyalgia in patients with other rheumatic diseases: prevalence and relationship with disease activity. Rheumatol Int. 2014 Sep;34:1275-80.
• 7. Walitt B, Nahin RL, Katz RS, Bergman MJ, Wolfe F. The Prevalence and Characteristics of Fibromyalgia in the 2012 National Health Interview Survey.PLoS One. 2015;10:e0138024.
• 8. Rebollo Rubio A, Morales Asencio JM, Eugenia Pons Raventos M. Depression, anxiety and health-related quality of life amongst patients who are starting dialysis treatment. J Ren Care. 2017 Feb 27.
• 9. Moreira JM, Bouissou Morais Soares CM, Teixeira AL, Simões E Silva AC, Kummer AM. Anxiety, depression, resilience and quality of life in children and adolescents with pre-dialysis chronic kidney disease. Pediatr Nephrol. 2015;30:2153-62.
• 10. Heidari F, Afshari M, Moosazadeh M. Prevalence of fibromyalgia in general population and patients, a systematic review and meta-analysis. Rheumatol Int.2017 Apr 26.
• 11. Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Katz RS, Mease P, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken). 2010;62:600-10.
• 12. Wolfe F, Clauw DJ, Fitzcharles MA, Goldenberg DL, Häuser W, Katz RS, et al. Fibromyalgia criteria and severity scales for clinical and epidemiological studies: a modification of the ACR Preliminary Diagnostic Criteria for Fibromyalgia. J Rheumatol. 2011;38:1113-22.
• 13. Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L. The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum. 1995;38:19-28.
• 14. Samimagham H, Haghighi A, Tayebi M, Jenabi A, Arabi M, Kianmehr N. Prevalence of fibromyalgia in hemodialysis patients. Iran J Kidney Dis. 2014;8:236-9.
• 15. Azevedo VF, Paiva Edos S, Felippe LR, Moreira RA. Occurrence of fibromyalgia in patients with ankylosing spondylitis. Rev Bras Reumatol. 2010;50:646-50.
• 16. Tishler M, Smorodin T, Vazina-Amit M, Ramot Y, Koffler M, Fishel B. Fibromyalgia in diabetes mellitus. Rheumatol Int. 2003;23:171-3.
• 17. Marvisi M, Balzarini L, Mancini C, Ramponi S, Marvisi C. Fibromyalgia is frequent in obstructive sleep apnea and responds to CPAP therapy. Eur J Intern Med. 2015;26:49-50.
• 18. Golan E, Haggiag I, Os P, Bernheim J. Calcium, parathyroid hormone, and vitamin D: major determinants of chronic pain in hemodialysis patients. Clin J Am Soc Nephrol. 2009;4:1374-80.
• 19. Leblebici B, Özelsancak R, Yılmaz EE, Doruk P. Fibromyalgia syndrome in Turkish hemodialysis patients. Hemodial Int. 2016;20:106-10.
• 20. Couto CI, Natour J, Carvalho AB. Fibromyalgia: its prevalence and impact on the quality of life on a hemodialyzed population. Hemodial Int. 2008;12:66-72.
• 21. Yuceturk TE, Yucel AE, Yuceturk H, Kart-Koseoglu H, Unuvar R, Ozdemir FN, et al. Fibromyalgia: its prevalence in haemodialysis patients and its relationships with clinical and laboratory parameters. Nephrol Dial Transplant.2005;20:2485-8.