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HEMODİYALİZ HASTALARINDA KEMİK MİNERAL YOĞUNLUĞUNDA AZALMAYA NEDEN OLABİLEN RİSK FAKTÖRLERİ

Journal Name:

  • İstanbul Tıp Fakültesi Dergisi

Publication Year:

  • 2003

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
SUMMARY Risk factors far reduced bone density in haemodialysis /?«f/ertfs.Haemodiarysis patİcnts are li-kely to have low bone mineral deusity (BMD) due to a combination of sevcral alterations in bone and mineral metabolism. We investigated the prevalance of reduced BMD and its associ-ation with age, sex, body mass index, duration of diaîysis, caleium and phosphorus levels, alkaline phosphatase, heparin dose, erythropoietİn, serum ferritin, hacmoglobin, urea reduetion ratio (%), İntact parathyroİd hormone (PTH) and caleium (mg/day) and alphacalcidiol supple-ment. The study population involved 35 patİcnts on ehronic hemodialysis (female/male=16/19, mean age=49.6 ± 16.2). BMD was measured at the lumbar spine (LS) and femoral neck (FN) with dual-energy X-ray absorptiometry (DEXA). Using the WHO criteria, osteopenia was defined as a T scorc of bctween -1.0 and -2.5 and osteoporosis as < 2.5. Statistical analysİs werc per-foımed using Pearson's correlation coeffıcients. İn 24 patients (69 %), LS and/or FN-BMD were more Ihan 1 SD bclow young adult mean va-luc. Mean values (± SD): LS-BMD (T score): -2.17 + 1.47; FN-BMD (T-score): -1.İ5 ± 1.55; PTH: 266.5 ± 420.6 pg/dL; AP: 138.6 ± 90.4 U/L; caleium: 9.8 ± 0.9 mg/dL; phosphorus: 5.1 ±1.4 mg/dL. We found a significant and negative correlation between age and FN-BMD (r= -0.55, p<0.05) and LS-BMD (r= -0.42, p<0.05). Negative correlations werc found between PTH and LS-BMD (r= -0.53, p<0.01) and FN-BMD (r= -0.34, p<0.01). Thcre was a strong correlation bctvveen LS-BMD and FN-BMD (r= 0.73, p<0.01). We have confirmed the importance of PTH-related bone dİsease in affeeting BMD in haemodialysis patients. Except PTH and age, uone of the other parameters werc found to be related with BMD
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Abstract (Original Language): 
Hemodiyaliz hastalarında kemik ve mineral metabolizmasındaki bazı değişikliklere bağlı olarak kemik mineral yoğunluğu (KMY) azalmaktadır. Azalmış KMY prevalansım ve bu azalmanın yaş, cinsiyet, beden kitle indeksi (BKİ), diyaliz süresi, kalsiyum ve fosfor düzeyleri, alka-Icn fosfataz, heparin dozu, eritropolein, serum ferritin, hemoglobin, üre azalma oranı(%), in-takt parathormon(PTH), kalsiyum ve alfakalsidiol takviyesi ile ilişkisini araştırdık. 35 kronik hemodiyaliz hastasında (K/E: 16/19; ortalama yaş: 49.6+16.2) KMY lomber verlebra (LV) ve femur boynundan (FB) dual-enerji X-ray absorpsiyometri (DEXA) yöntemiyle ölçüldü. İstatistiksel analizler Pearson korelasyon katsayısı ile yapıldı. 24 hastada (%69), LV ve/veya FB-KMY genç erişkin oratalama değerinden 1SD daha düşüktü. Ortalama değerler (±SD): LV-KMY(T skoru): -2.17+1.47; FB-KMY(T skoru): -1.15 ± 1.55; PTH: 266.5 ± 420.6 pg/dL; AP:138.6(90.4 u/L; kalsiyum:9.8 ± 0.9 mg/dL; fosfor: 5.1 ± 1.4 mg/dL bulundu. Yaş ile FB-KMY(r=-0.55, p<0.05) ve LV-KMY (r^-0.42; p<0.05) arasında anlamlı negatif korelasyon vardı. PTH ile LV-KMY (r=-0.53, p<0.01) ve FB-KMY (r=-0.34, p<0,01) arasında negatif korelasyon vardı. LV-KMY ile FB-KMY arasında kuvvetli korelasyon vardı (r=0.73, p<0.01). Hemodiyaliz hastalarında PTH İİe ilişkili kemik hastalığının KMY üzerindeki Önemini doğruladık. PTH ve yaş dışında diğer hiçbir parametre KMY'deki azalma ile ilişkili bulunmadı
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  • 4
223-228
  • Turkish

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