The frequency of the fibromyalgia syndrome in patients with kidney transplantation and evaluation of related factors

ABSTRACT The Frequency of the Fibromyalgia Syndrome in Patients with Kidney Transplantation and Evaluation of Related Factors Fibromyalgia syndrome (FMS) is a multisystemic disorder characterized by chronic, generalized myo-skeletal pain. Besides chronic pain other co-morbities such as fatigue, sleep disorders, malfunction, depression, anxiety and cognitive dysfunctions could also be seen. The prevalence of FMS is approximately 02-5.8%. We could not find any data related with the prevalence and clinical course of FMS in renal transplant recipients. We aimed to find out the prevalence and related factors with FMS in renal transplant recipients. One hundred and twenty-eight end stage renal disease patients who had renal transplant during January 1998-december 2013 at University of Baskent Faculty of Medicine Ankara Hospital enrolled the study. Inclusion criteria included patients with serum creatinin levels <2.5 mg/dl, who do not have osteoporosis, not considered as rejection period, with normal levels of serum CRP and sedimentation levels and patients on regular controls. Patients' data including age, gender, marital status, cigarette smoking, primary disorder, immunosuppressive treatment regimens were collected from patients' medical records. FMS is diagnosed according to ACR 1990 criteria. A subgroup of patients who did not fulfilled the ACR criteria but also could not be thought as normal subjects were called as "probable FMS". According these criteria 13 and 7 of 128 patients were diagnosed as having FMS and probable FMS respectively. All patients diagnosed with FMS are female, have significantly higher levels of malaise, irritable bowel syndrome, sleep disorders, depression with a frequency of 46% and on antidepressive medications with a frequency of 30%. However swelling of joints, paresthesia and restless leg syndrome were seen in similar fashion with normal controls. In our study we have found that "Fibromyalgia Impact Questionnaire-FIQ" scores were significantly higher at FMS and probable FMS patients (p<0.001) and we have noticed that as FIQ scores increases the frequency of FMS diagnosis also increased. This data shows as that FIQ score could be an independent risk factor at diagnosing FMS. In conclusion we have noticed a prevalence of 10.15% FMS patients at 128 renal transplant recipients which is at least two times a higher value than people with normal renal function. We can mention as high as 15.6% FMS prevalence at 128 renal transplant recipients when we consider adding patients with diagnosis of probable FMS. Possible explanations for these results could be; using multiple drugs, frequent visits at hospital for other reasons such as infections or rejection, fear of losing the graft, the hard period of hemodialysis and transplantation that precipites psychosomatic disorders at patients, lower pain thresholds triggered by chronic and serious problematic co-morbid illnesses. Key Words: Renal transplantation, fibromyalgia syndrome