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Morphometric magnetic resonance imaging study of the quadriceps tendon in hemodialysis patients: comparison with non-dialyzed controls

Estudo morfométrico do tendão do quadríceps em pacientes em hemodiálise: avaliação por ressonância magnética e comparação com grupo controle

Abstract

Objective:

To evaluate the knees of individuals with renal failure who are on hemodialysis, using magnetic resonance imaging (MRI), comparing them with those of a group of individuals with normal renal function.

Materials and Methods:

This was a cross-sectional, observational, controlled study conducted between August 2018 and February 2020. The cases consisted of 15 patients who had been on hemodialysis for ≥ 5 years and did not have a quadriceps tendon rupture. The controls consisted of 15 individuals with normal renal function who were matched (1:1) to the cases for sex, age, and physical activity level. The subjects in both groups underwent MRI of the right knee only.

Results:

The mean ages of the cases and controls were 50 ± 15 years and 49 ± 14 years, respectively. The median time on hemodialysis was 11 years (range, 10-14 years). Serum levels of parathyroid hormone, ferritin, alkaline phosphatase, phosphorus, and creatinine were higher among the cases than among the controls, whereas serum albumin and hemoglobin were lower (p < 0.05 for all). The MRI study showed a hyperintense signal in the quadriceps tendon in 11 of the cases and in three of the controls (p = 0.009). Knee joint effusion was observed in nine of the cases and in three of the controls (p < 0.05). The thickness, length, and width of the tendon did not differ between the groups. A hyperintense signal in the tendon was not associated with the time on hemodialysis; nor with the levels of intact parathyroid hormone, hemoglobin, or alkaline phosphatase.

Conclusion:

Patients on chronic hemodialysis, even those without a tendon rupture, show a hyperintense signal in the quadriceps tendon on MRI.

Keywords:
Tendons/pathology; Magnetic resonance imaging; Renal insufficiency; chronic/complications; Renal dialysis; Risk factors; Hyperparathyroidism

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