The effect of chronic kidney disease in patients with spontaneous spondylodiscitis

Objective: Spontaneous spondylodiscitis is a rare but serious infectious disease of the vertebral column that can lead to permanent neurological deficits. We investigated the differences during follow-up of this pathology, which is more common in patients undergoing hemodialysis (HD) treatment for chronic kidney disease (CKD), compared with the general population. Materials and Methods: The data of patients who were treated for spontaneous spondylodiscitis between 2016-2021 at the Başkent University Department of Neurosurgery were used retrospectively. The patients were divided into 2 groups according to the diagnosis of CKD. Demographic data of the patients, biochemical values at the time of diagnosis (C-reactive protein, sedimentation, leukocyte, lymphocyte), microbiological and pathological examination results, and treatment method (surgical, medical) applied after diagnosis was obtained from the medical records. The effects of CKD presence and treatment methods on patient survival were investigated. Results: Of the 49 patients included in the study, 57.1% were female and the mean age was 66 years. Twenty-four of the patients were chronic HD patients. The microbiological examination of the samples taken determined that the causative pathogen could be produced in the cultures of 21 (42.8%) patients. According to the results of the pathological examination, signs of infection were detected in 24 (48.9%) patients. It was determined that 27 of the patients were operated. There was a central venous catheter in 20 of the patients. There was no statistically significant difference in survival between the groups that were operated on for instability and those that were not operated on. However, chronic renal failure and the presence of central venous catheters increased mortality statistically significantly. Conclusion: In the presence of back pain in chronic HD patients, spondylodiscitis should be suspected and diagnosed at an early stage, even if there is no fever or high infection parameters. Finally, great emphasis on disinfection procedures and aseptic techniques in patients with central venous catheters protected from these serious infectious complications.