Skip to main content

Function Assessment in Metabolic Disorders: Diabetes Mellitus, Hemodialysis, and Gout

  • Chapter
  • First Online:
Hand Function
  • 1417 Accesses

Abstract

Metabolic diseases affect the function of the hand by making musculoskeletal involvement

Metabolic diseases, including chronic renal failure undergoing hemodialysis, gout, and diabetes mellitus, impair hand function by affecting musculoskeletal system, causing hemodynamic, vascular, or neurological dysfunctions. Carpal tunnel syndrome (CTS), destructive arthropathy, bone cyst, bone erosions, and tendon abnormalities are seen in the patients receiving hemodialysis. Diabetes mellitus is associated with an increased incidence of functional disability. The complications of diabetes mellitus seen in the hand are diabetic stiff hand syndrome, Dupuytren’s disease, CTS, trigger finger, complex regional pain syndrome type-1, and neuropathy. Patients with gout have monosodium urate crystals deposited in the tendon, joints, and nerve. Tophi leads to destructive arthropathy and presents on the fingers and volar surface of the hands. Muscle strength test, range-of-motion evaluation, hand dexterity, and daily activity tests could be conducted to assess the extent of damage in those patients. In this chapter, the musculoskeletal and the other involvements of the hand were mentioned. Additionally, the tests evaluating hand functions and index which were used for evaluating hand disability were reviewed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Kessler M, Netter P, Azoulay E, Mayeux D, Péré P, Gaucher A. Dialysis-associated arthropathy: a multicenter survey of 171 patients receiving haemodialysis for over 10 years. Br J Rheumatol. 1992;31:157–62.

    Article  CAS  Google Scholar 

  2. Kay J. β2 microglobulin amyloidosis. Int J Experimental Clin Investig. 1997;4:187–211.

    CAS  Google Scholar 

  3. Kay J, Bardin T. Osteoarticular disorders of renal origin: disease related and iatrogenic. Baillieres Best Pract Res Clin Rheumatol. 2000;14(2):285–305.

    Article  CAS  Google Scholar 

  4. Jadoul M, Garbar C, Noël H, Sennesael J, Vanholder R, Bernaert P, Rorive G, Hanique G, van Ypersele de Strihou C. Histological prevalence of beta 2-microglobulin amyloidosis in hemodialysis: a prospective post-mortem study. Kidney Int. 1997;51(6):1928–32.

    Article  CAS  Google Scholar 

  5. Scali ST, Huber TS. Treatment strategies for access-related hand ischemia. Semin Vasc Surg. 2011;24(2):128–36.

    Article  Google Scholar 

  6. Malik J, Tuka V, Kasalova Z, Chytilova E, Slavikova M, Clagett P, Davidson I, Dolmatch B, Nichols D, Gallieni M. Understanding the dialysis access steal syndrome. A review of the etiologies, diagnosis, prevention and treatment strategies. J Vasc Access. 2008;9(3):155–66.

    Article  CAS  Google Scholar 

  7. Hirasawa Y, Ogura T. Carpal tunnel syndrome in patients on long-term haemodialysis. Scand J Plast Reconstr Surg Hand Surg. 2000;34:373–81.

    Article  CAS  Google Scholar 

  8. Nakamoto HA, Ferreira MC, Tustumi F, et al. Sensory testing in patients with hemodialysis-associated carpal tunnel syndrome submitted to surgical decompression. Ann Plast Surg. 2014;72:685–8.

    Article  CAS  Google Scholar 

  9. Kurer MH, Baillod RA, Madgwick JC. Musculoskeletal manifestations of amyloidosis. A review of 83 patients on haemodialysis for at least 10 years. J Bone Joint Surg Br. 1991;73:271–6.

    Article  Google Scholar 

  10. Martinez J, Forts P, Falgás J, Martinez E, Mascort I, Plans A, Rotellar E. Carpal tunnel syndrome and chronic hemodialysis. Am J Nephrol. 1985;5(6):476.

    Article  CAS  Google Scholar 

  11. Kumar S, Trivedi HL, Smith EK. Carpal tunnel syndrome: a complication of arteriovenous fistula in hemodialysis patients. Can Med Assoc J. 1975;113:1070–2.

    CAS  PubMed  PubMed Central  Google Scholar 

  12. Schwarz A, Keller F, Seyfert S, Pöll W, Molzahn M, Distler A. Carpal tunnel syndrome: a major complication in long-term hemodialysis patients. Clin Nephrol. 1984;22:133–7.

    CAS  PubMed  Google Scholar 

  13. Namazi H, Majd Z. Carpal tunnel syndrome in patients who are receiving long-term renal hemodialysis. Arch Orthop Trauma Surg. 2007;127(8):725–8.

    Article  Google Scholar 

  14. Flipo RM, Loet L, Siame JL, et al. Destructive arthropathy of the hand in patients treated by long term hemodialysis. Seven cases with pathologic examination. Rev Rheum Engl Ed. 1995;62:241.

    CAS  Google Scholar 

  15. Maruyama H, Gejyo F, Arakawa M. Clinical studies of destructive spondyloarthropathy in long-term hemodialysis patients. Nephron. 1992;61(1):37–44.

    Article  CAS  Google Scholar 

  16. Cotten A, Flipo RM, Boutry N, et al. Natural course of erosive arthropathy of the hand in patients undergoing hemodialysis. Skelet Radiol. 1997;26:20e6.

    Article  Google Scholar 

  17. Kim D, Choi IC, Park JW. Severe destructive tendinopathy in the wrist due to dialysis-related amyloidosis. J Hand Surg Asian Pac Vol. 2017;22(3):376–9.

    Article  Google Scholar 

  18. Uehara K, Hozumi T, Yamakawa K. Spontaneous rupture of the extensor pollicis longus tendon in a patient with hyperparathyroidism undergoing chronic haemodialysis. J Hand Surg Eur Vol. 2013;38(2):213–5.

    Article  CAS  Google Scholar 

  19. Rosenfeld N, Rascoff JH. Tendon ruptures of the hand associated with renal dialysis. Plast Reconstr Surg. 1980;65(1):77–9.

    Article  CAS  Google Scholar 

  20. Ross LV, Ross GJ, Mesgarzadeh M, Edmonds PR, Bonakdarpour A. Hemodialysis-related amyloidomas of bone. Musculoskeletal Radiol. 1991;178(1):263–5.

    CAS  Google Scholar 

  21. Sargent MA, Fleming SJ, Chattopadhyay C, Ackrill P, Sambrook P. Bone cysts and hemodialysis-related amyloidosis. Clin Radiol. 1989;40:277–81.

    Article  CAS  Google Scholar 

  22. DiRaimondo CR, Casey TT, DiRaimondo CV, Stone WJ. Pathologic fractures associated with idiopathic amyloidosis of bone in hemodialysis patients. Nephron. 1986;43:22–7.

    Article  CAS  Google Scholar 

  23. Fitzpatrick DC, Jebson PJ, Madey SM, Steyers CM. Upper extremity musculoskeletal manifestations of dialysis-associated amyloidosis. Iowa Orthop J. 1996;16:135–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  24. Lindstedt E, Westling H. Effects of antebrachial cimino-brescia arteriovenous fistula on the local circulation in the hand. Scand J Urol Nephrol. 1975;9:119–24.

    Article  CAS  Google Scholar 

  25. Limaye V, Frankham A, Disney A, Pile K. Evaluation of hand function in patients undergoing long term haemodialysis. Ann Rheum Dis. 2001;60(3):278–80.

    Article  CAS  Google Scholar 

  26. Duruöz MT, Cerrahoglu L, Dincer-Turhan Y, Kürsat S. Hand function assessment in patients receiving haemodialysis. Swiss Med Wkly. 2003;133(31–32):433–8.

    PubMed  Google Scholar 

  27. Cuppari L, Avesani CM, Mendonça COG. Doenças Renais. In: Cuppari L, editor. Guias de Medicina ambulatorial e hospitalar. Unifesp/Escola Paulista de Medicina, Nutrição. 2nd ed. Manole: São Paulo; 2005. p. 189–220.

    Google Scholar 

  28. Fouque D, Kalantar-Zadeh K, Kopple J, Cano N, Chauveau P, Cuppari L, Franch H, Guarnieri G, Ikizler TA, Kaysen G, Lindholm B, Massy Z, Mitch W, Pineda E, Stenvinkel P, Treviño-Becerra A, Wanner C. A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease. Kidney Int. 2008;73:391–8.

    Article  CAS  Google Scholar 

  29. Vogt BP, Borges MCC, Goés CR, Caramori JCT. Handgrip strength is an independent predictor of all-cause mortality in maintenance dialysis patients. Clin Nutr. 2016;35(6):1429–33.

    Article  Google Scholar 

  30. Norman K, Stobäus N, Gonzalez MC, Schulzke JD, Pirlich M. Hand grip strength: outcome predictor and marker of nutritional status. Clin Nutr. 2011;30(2):135–42.

    Article  Google Scholar 

  31. Mathiowetz V, Weber K, Volland G, Kashman N. Reliability and validity of grip and pinch strength evaluations. J Hand Surg. 1984;9A:222–6.

    Article  Google Scholar 

  32. Buddenberg LA, Davis C. Test-retest reliability of the Purdue Pegboard test. Am J Occup Ther. 2000;54(5):555–8.

    Article  CAS  Google Scholar 

  33. Sollerman C. Assessment of grip function: evaluation of a new test method. Doctoral dissertation. Goteborg: University of Goteborg; 1980.

    Google Scholar 

  34. Tander B, Akpolat T, Durmus D, Canturk F. Evaluation of hand functions in hemodialysis patients. Ren Fail. 2007;29(4):477–80.

    Article  Google Scholar 

  35. Chazot C, Chazot I, Charra B, Terrat JC, Vanel T, Calemard E, Ruffet M, Laurent G. Functional study of hands among patients dialysed for more than 10 years. Nephrol Dial Transplant. 1993;8(4):347–51.

    CAS  PubMed  Google Scholar 

  36. Branz NR, Newton RA. Hand function in patients on maintenance hemodialysis. Phys Ther. 1988;68(7):1092–7.

    Article  CAS  Google Scholar 

  37. Duruo¨z MT, Poiraudeau S, Fermanian J, et al. Development and validation of a rheumatoid hand functional disability scale that assesses functional handicap. J Rheumatol. 1996;23:1167–72.

    Google Scholar 

  38. Rehfuss JP, Berceli SA, Barbey SM, He Y, Kubilis PS, Beck AW, Huber TS, Scali ST. The spectrum of hand dysfunction after hemodialysis fistula placement. Kidney Int Rep. 2017;2(3):332–41.

    Article  Google Scholar 

  39. Smith LL, Burnet SP, McNeil JD. Musculoskeletal manifestations of diabetes mellitus. Br J Sports Med. 2003;37:30–5.

    Article  CAS  Google Scholar 

  40. Gamstedt A, Holm-Glad J, Ohlson CG, Sundstrom M. Hand abnormalities are strongly associated with the duration of diabetes mellitus. J Intern Med. 1993;234:189.

    Article  CAS  Google Scholar 

  41. Casanova JE, Casanova JS, Young MJ. Hand function in patients with diabetes mellitus. South Med J. 1991;84(9):1111–3.

    Article  CAS  Google Scholar 

  42. Ramchurn N, Mashamba C, Leitch E, Arutchelvam V, Narayanan K, Weaver J, et al. Upper limb musculoskeletal abnormalities and poor metabolic control in diabetes. Eur J Intern Med. 2009;20:718–21.

    Article  Google Scholar 

  43. Redmond CL, Bain GI, Laslett LL, McNeil JD. Hand syndromes associated with diabetes: impairments and obesity predict disability. J Rheumatol. 2009;36(12):2766–71.

    Article  Google Scholar 

  44. Nathan DM. The pathophysiology of diabetic complications: how much does the glucose hypothesis explain? Ann Intern Med. 1996;124(1 Pt 2):86–9.

    Article  CAS  Google Scholar 

  45. Brownlee M. Glycation products and the pathogenesis of diabetic complications. Diabetes Care. 1992;15(12):1835–43.

    Article  CAS  Google Scholar 

  46. Rosenbloom AL, Silverstein JH. Connective tissue and joint disease in diabetes mellitus. Endocrinol Metab Clin N Am. 1996;25(2):473–83.

    Article  CAS  Google Scholar 

  47. Papanas N, Maltezos E. The diabetic hand: a forgotten complication? J Diabetes Complicat. 2010;24(3):154–62.

    Article  Google Scholar 

  48. Larkin ME, Barnie A, Braffett BH, Cleary PA, Diminick L, Harth J, Gatcomb P, Golden E, Lipps J, Lorenzi G, Mahony C, Nathan DM, Diabetes control and complications trial/epidemiology of diabetes interventions and complications research group. Musculoskeletal complications in type 1 diabetes. Diabetes Care. 2014;37(7):1863–9.

    Article  Google Scholar 

  49. Mustafa KN, Khader YS, Bsoul AK, Ajlouni K. Musculoskeletal disorders of the hand in type 2 diabetes mellitus: prevalence and its associated factors. Int J Rheum Dis. 2016;19(7):730–5.

    Article  CAS  Google Scholar 

  50. Ramchurn N, Mashamba C, Leitch E, Arutchelvam V, Narayanan K, Weaver J, Hamilton J, Heycock C, Saravanan V, Kelly C. Upper limb musculoskeletal abnormalities and poor metabolic control in diabetes. Eur J Intern Med. 2009;20(7):718–21.

    Article  Google Scholar 

  51. Sauseng S, Kästenbauer T, Irsigler K. Limited joint mobility in selected hand and foot joints in patients with type 1 diabetes mellitus: a methodology comparison. Diabetes Nutr Metab. 2002;15:1–6.

    CAS  PubMed  Google Scholar 

  52. Yosipovitch G, Mukamel M, Karp M. Diabetic hand syndrome in juvenile diabetics. Harefuah. 1990;119(3–4):63–6.

    CAS  PubMed  Google Scholar 

  53. Crispin JC, Alcocer-Varela J. Rheumatologic manifestations of diabetes mellitus. Am J Med. 2003;114:753–7.

    Article  Google Scholar 

  54. Ardic F, Soyupek F, Kahraman Y, Yorgancioglu R. The musculoskeletal complications seen in type II diabetics: predominance of hand involvement. Clin Rheumatol. 2003;22(3):229–33.

    Article  CAS  Google Scholar 

  55. Chammas M, Bousquet P, Renard E, Poirier JL, Jaffiol C, Allieu Y. Dupuytren’s disease, carpal tunnel syndrome, trigger finger, and diabetes mellitus. J Hand Surg Am. 1995;20(1):109–15.

    Article  CAS  Google Scholar 

  56. Arkkila PE, Gautier JF. Musculoskeletal disorders in diabetes mellitus: an update. Best Pract Res Clin Rheumatol. 2003;17:945–70.

    Article  CAS  Google Scholar 

  57. Childs SG. Dupuytren’s disease. Orthop Nurs. 2005;24:160–4.

    PubMed  Google Scholar 

  58. Jennings AM, Milner PC, Ward JD. Hand abnormalities are associated with the complications of diabetes in type 2 diabetes. Diabet Med. 1989;6(1):43–7.

    Article  CAS  Google Scholar 

  59. Yang CJ, Hsu HY, Lu CH, Chao YL, Chiu HY, Kuo LC. The associations among hand dexterity, functional performance, and quality of life in diabetic patients with neuropathic hand from objective- and patient-perceived measurements. Qual Life Res. 2015;24(1):213–22.

    Article  Google Scholar 

  60. Cetinus E, Buyukbese MA, Uzel M, Ekerbicer H, Karaoguz A. Hand grip strength in patients with type 2 diabetes mellitus. Diabetes Res Clin Pract. 2005;70(3):278–86.

    Article  Google Scholar 

  61. Savas S, Koroglu BK, Koyuncuoglu HR, Uzar E, Celik H, Tamer NM. The effects of the diabetes related soft tissue hand lesions and the reduced hand strength on functional disability of hand in type 2 diabetic patients. Diabetes Res Clin Pract. 2007;77(1):77–83.

    Article  Google Scholar 

  62. Shah KM, Clark BR, McGill JB, Mueller MJ. Upper extremity impairments, pain and disability in patients with diabetes mellitus. Physiotherapy. 2015;101(2):147–54.

    Article  CAS  Google Scholar 

  63. American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2008;31(Suppl 1):12–54.

    Article  Google Scholar 

  64. Dutch Association of Neurology (NVN), Dutch Association of Clinical Neurophysiology (NVKNF). Guideline polyneuropathy of the Dutch institute for healthcare improvement (CBO). Alphen a/d Rijn: van Zuiden; 2005.

    Google Scholar 

  65. Bell-Krotoski JA. Sensibility testing with the Semmes–Weinstein monofilaments. In: Mackin EJ, Callahan AD, Skirven TM, Schneider LH, Osterman AL, editors. Rehabilitation of the hand and upper extremity. 5, vol. 1. St Louis: Mosby; 2002. p. 194–213.

    Google Scholar 

  66. NHS National Institute for Clinical Excellence (NICE). Type 2 diabetes prevention and management of foot problems, clinical guideline 10. London: National Institute for Clinical Excellence (NICE); 2004.

    Google Scholar 

  67. Mueller MJ. Identifying patients with diabetes mellitus who are at risk for lower-extremity complications: use of Semmes-Weinstein monofilaments. Phys Ther. 1996;76(1):68–71.

    Article  CAS  Google Scholar 

  68. Valk GD, de Sonnaville JJ, van Houtum WH, Heine RJ, van Eijk JT, Bouter LM, Bertelsmann FW. The assessment of diabetic polyneuropathy in daily clinical practice: reproducibility and validity of Semmes Weinstein monofi laments examination and clinical neurological examination. Muscle Nerve. 1997;20(1):116–21.

    Article  CAS  Google Scholar 

  69. Dros J, Wewerinke A, Bindels PJ, van Weert HC. Accuracy of monofilament testing to diagnose peripheral neuropathy: a systematic review. Ann Fam Med. 2009;7(6):555–8.

    Article  Google Scholar 

  70. Travieso D, Lederman SJ. Assessing subclinical tactual deficits in the hand function of diabetic blind persons at risk for peripheral neuropathy. Arch Phys Med Rehabil. 2007;88(12):1662–72.

    Article  Google Scholar 

  71. Turan Y, Duruöz MT, Aksakalli E, Gürgan A. Validation of Duruöz Hand Index for diabetic hand dysfunction. J Investig Med. 2009;57(8):887–91.

    Article  Google Scholar 

  72. Chiu HY, Hsu HY, Kuo LC, Su FC, Yu HI, Hua SC, Lu CH. How the impact of median neuropathy on sensorimotor control capability of hands for diabetes: an achievable assessment from functional perspectives. PLoS One. 2014;9(4):e94452.

    Article  Google Scholar 

  73. Smith EU, az-Torne C, Perez-Ruiz F, March LM. Epidemiology of gout: an update. Best Pract Res Clin Rheumatol. 2010;24:811–27.

    Article  CAS  Google Scholar 

  74. Lottmann K, Chen X, Schadlich PK. Association between gout and all-cause as well as cardiovascular mortality: a systematic review. Curr Rheumatol Rep. 2012;14:195–203.

    Article  Google Scholar 

  75. Scire CA, Manara M, Cimmino MA, Govoni M, Salaffi F, Punzi L, Monti MC, Carrara G, Montecucco C, Matucci-Cerinic M, Minisola G, Study Collaborators KING. Gout impacts on function and health-related quality of life beyond associated risk factors and medical conditions: results from the KING observational study of the Italian Society for Rheumatology (SIR). Arthritis Res Ther. 2013;15(5):R101.

    Article  Google Scholar 

  76. Dalbeth N, Collis J, Gregory K, Clark B, Robinson E, McQueen FM. Tophaceous joint disease strongly predicts hand function in patients with gout. Rheumatology (Oxford). 2007;46(12):1804–7.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Soyupek, F., Akkuş, S. (2019). Function Assessment in Metabolic Disorders: Diabetes Mellitus, Hemodialysis, and Gout. In: Duruöz, M. (eds) Hand Function. Springer, Cham. https://doi.org/10.1007/978-3-030-17000-4_18

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-17000-4_18

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-16999-2

  • Online ISBN: 978-3-030-17000-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics