Lower back pain in a patient on long-term haemodialysis

Abstract

A 60-year-old woman with end-stage renal disease secondary to adult polycystic kidney disease, presented with a 6-month history of worsening sacral and rectal pain. She reported anorexia and significant weight loss. She was on haemodialysis for 5 years prior to receiving a renal transplant, which failed after 8 years. She was then recommenced haemodialysis for another 4 years to date. She underwent bilateral nephrectomy of her native kidneys prior to transplantation. Clinical examination showed cachexia, hepatomegaly and a right iliac fossa graft. Rectal examination was normal. Passive movements of both lower limbs were painful; however, there was no neurological deficit.