INTRODUCTION: 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 fi nger 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 signifi cantly 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 fi nger 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.
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