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Periton Diyaliz Hastalarında Kemik Mineral Dansitometresi ile Damar Kireçlenmesi (Vasküler Kalsifi kasyon) Arasındaki İlişki

The Relationship Between Bone Mineral Densitometry and Vascular Calcifi cation in Peritoneal Dialysis Patients

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DOI: 
DOI 10.5262/tndt.2012.1003.07
Abstract (2. Language): 
OBJECTIVE: Vascular calcifi cation (VC) and disturbed bone mineral metabolism (BMM) are commonly seen in patients with end-stage renal disease (ESRD). Fetuin-A has been found to be signifi cantly low in ESRD patients. The aim of our study was to investigate the relation between coronary artery calcifi cation, BMM and fetuin-A in peritoneal dialysis (PD) patients. MATERIAL and METHODS: 46 PD (M/F=28/18) patients were included in the study. Coronary artery calcifi cation scoring (CACS) was performed by multi slice computed tomography. The patients were divided into 4 groups according to their CACS values as Group 1 (CACS: 0), Group 2 (CACS:1- 99), Group 3 (CACS:100-399) and Group 4 (CACS: ≥400). Serum levels of fetuin-A were measured. Bone mineral densitometry was measured by dual energy X-ray absorptiometer (DEXA). RESULTS: There was a statistically signifi cant difference difference between CACS and femur T scores in PD patients. Femur T scores were found to be decreased while CACS values are increased. We could not fi nd any differences in terms of CACS when we separated patients according to T scores greater or lower than -2. Osteopenic patients were found to be older and they also had low fetuin-A levels. CONCLUSION: We found an important relationship between CACS and bone mineralization in PD patients.
Abstract (Original Language): 
AMAÇ: Son dönem böbrek yetersizliği (SDBY) gelişen hastalarda damar kireçlenmesi (DK) ve kemik mineral metabolizma (KMM) bozukluğu yaygın olarak gözlenmektedir. SDBY hastalarında fetuin-A düzeyinin ileri derecede düşük olduğu saptanmıştır. Çalışmamızın amacı periton diyaliz (PD) hastalarında koroner arter kireçlenmesi (KAKS), KMM ve fetuin-A arasındaki ilişkiyi incelemektir. GEREÇ ve YÖNTEMLER: Çalışmamıza 46 PD (E/K=28/18) hastası alınmıştır. Hastalara çok kesitli bilgisayarlı tomografi ile koroner arter kalsiyum skorlaması (KAKS) yapıldı. KAKS değerlerine göre hastalar Grup 1 (KAKS 0), Grup 2 (KAKS: 1-99), Grup 3 (KAKS: 100-399) ve Grup 4 (KAKS: ≥400) olmak üzere 4 gruba ayrıldı. Serumda fetuin-A düzeyi çalışıldı. DEXA ile kemik mineral dansitometresi ölçüldü. BULGULAR: Periton diyaliz hastalarının KAKS ile femur T skorları arasında istatistiksel olarak anlamlı ilişki saptanmıştır. Hastalarının KAKS’ı arttıkça femur T skoru azalmaktaydı. Buna ek olarak T skoru -2’nin altında ve üstünde olan hastalar karşılaştırıldığında KAKS değerleri bakımından anlamlı bir farklılık saptanmamıştır. İstatistiksel açıdan anlamlı olmamakla birlikte osteopenik olan PD hastaları daha yaşlıydı ve bu hastaların fetuin-A değerleri daha düşüktü. SONUÇ: Periton diyaliz hastalarında KAKS ile kemik mineralizasyonu arasındaki anlamlı bir ilişki saptadık.
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