Posters
The Association of Secondary Hyperparathyroidism and Tendon Ruptures in Patients Undergoing Dialysis
Presenting Author Academic/Professional Position
Medical Student
Academic Level (Author 1)
Medical Student
Academic Level (Author 2)
Undergraduate
Academic Level (Author 3)
Medical Student
Academic Level (Author 4)
Medical Student
Academic Level (Author 5)
Faculty
Discipline/Specialty (Author 5)
Orthopedic Surgery
Presentation Type
Poster
Discipline Track
Clinical Science
Abstract Type
Research/Clinical
Abstract
Background: Spontaneous tendon ruptures are rare occurrences observed in dialysis patients and are strongly correlated with secondary hyperparathyroidism. Secondary hyperparathyroidism occurs due to decreased renal function causing unregulated calcium and phosphate levels that can impact the parathyroid hormone (PTH) and weaken tendons. Increased PTH hormone causes bone resorption and calcification at tendon site which can further increase the likelihood of rupture. Tendon ruptures commonly occur in weight bearing tendons such as the quadriceps, patellar, and achilles tendon. Treatment management ranges from suture anchor fixation of tendons or tendon repair with immobilization followed by physiotherapy. Prevention can also be implemented with parathyroidectomies or medications such as vitamin D analogs, calcimimetics, or phosphate binders. This review aims to evaluate the risk factors, treatment, and success of recovery in dialysis patients that have experienced spontaneous tendon ruptures .
Methods: This systematic review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses PRISMA. The initial search included 314 articles and 10 articles met all the inclusion and exclusion criteria. Three databases were utilized: PubMed, Science Direct, and Sage Journals, using the Boolean operators - ((tendon disorder) AND (dialysis)) AND (hyperparathyroidism).
Results: A total of 63 dialysis patients experienced tendon rupture with secondary hyperparathyroidism. Quadriceps tendon ruptures were the most common with 41 patients (65%) and digital extensor tendons were the least common with only 4 patients (7%). Levels of parathyroid hormone (PTH) greater than 600 pg/mL were more associated with tendon rupture. The average level of PTH in patients that experienced tendon rupture was 1,802 pg/mL compared to controls that had an average of 202 pg/mL. Surgical treatment led to recovery in 90% of the cases. Patients who underwent parathyroidectomies demonstrated lower incidence of tendon rupture.
Conclusion: Spontaneous tendon ruptures are complications observed in dialysis patients experiencing secondary hyperparathyroidism. Although there is a wide ranging variety of tendon ruptures, the quadriceps tendon has been observed with increased rates. Although surgical management demonstrates high rates of success, rapid intervention is necessary. Prevention is also critical for patients undergoing dialysis, especially patients who have been undergoing chronic dialysis treatment.
Recommended Citation
Gutierrez, Yolanda V.; Rivera, Joaquin S.; Sepulveda, Alyssa S.; Shaju, Ronald S.; and Ahmad, Aamir, "The Association of Secondary Hyperparathyroidism and Tendon Ruptures in Patients Undergoing Dialysis" (2025). Research Symposium. 177.
https://scholarworks.utrgv.edu/somrs/2025/posters/177
Included in
The Association of Secondary Hyperparathyroidism and Tendon Ruptures in Patients Undergoing Dialysis
Background: Spontaneous tendon ruptures are rare occurrences observed in dialysis patients and are strongly correlated with secondary hyperparathyroidism. Secondary hyperparathyroidism occurs due to decreased renal function causing unregulated calcium and phosphate levels that can impact the parathyroid hormone (PTH) and weaken tendons. Increased PTH hormone causes bone resorption and calcification at tendon site which can further increase the likelihood of rupture. Tendon ruptures commonly occur in weight bearing tendons such as the quadriceps, patellar, and achilles tendon. Treatment management ranges from suture anchor fixation of tendons or tendon repair with immobilization followed by physiotherapy. Prevention can also be implemented with parathyroidectomies or medications such as vitamin D analogs, calcimimetics, or phosphate binders. This review aims to evaluate the risk factors, treatment, and success of recovery in dialysis patients that have experienced spontaneous tendon ruptures .
Methods: This systematic review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses PRISMA. The initial search included 314 articles and 10 articles met all the inclusion and exclusion criteria. Three databases were utilized: PubMed, Science Direct, and Sage Journals, using the Boolean operators - ((tendon disorder) AND (dialysis)) AND (hyperparathyroidism).
Results: A total of 63 dialysis patients experienced tendon rupture with secondary hyperparathyroidism. Quadriceps tendon ruptures were the most common with 41 patients (65%) and digital extensor tendons were the least common with only 4 patients (7%). Levels of parathyroid hormone (PTH) greater than 600 pg/mL were more associated with tendon rupture. The average level of PTH in patients that experienced tendon rupture was 1,802 pg/mL compared to controls that had an average of 202 pg/mL. Surgical treatment led to recovery in 90% of the cases. Patients who underwent parathyroidectomies demonstrated lower incidence of tendon rupture.
Conclusion: Spontaneous tendon ruptures are complications observed in dialysis patients experiencing secondary hyperparathyroidism. Although there is a wide ranging variety of tendon ruptures, the quadriceps tendon has been observed with increased rates. Although surgical management demonstrates high rates of success, rapid intervention is necessary. Prevention is also critical for patients undergoing dialysis, especially patients who have been undergoing chronic dialysis treatment.
