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Kronik Periton Diyalizi Hastalarında Kemik Mineral Dansitesi ile Vitamin D Düzeyleri Arasındaki İlişki

Relationship Between Bone Mineral Density and Vitamin D Levels in Patients Undergoing Chronic Peritoneal Dialysis

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2009

Key Words:

Keywords (Original Language):

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Abstract (2. Language): 
Low bone mineral density (BMD) is one of the risk factors for bone fracture. The incidence of bone fracture is highest among patients with chronic renal failure. There is little data about the BMD of patients undergoing chronic peritoneal dialysis (PD). In addition, dialysis patients with low vitamin D levels are at increased risk of early mortality. We investigated the incidence of osteopenia/osteoporosis and relationship between BMD and vitamin D levels in 28 peritoneal dialysis patients. Bone densitometry was studied by dual-energy x-ray absorptiometry (DEXA). Bone mass was classified as normal, osteopenic, or osteoporotic according to World Health Organization criteria. Serum 25-hydroxyvitamin D (25OHD) levels were measured in all patients. Of the 28 patients, 25.7% had osteoporosis and 27.9% had osteopenia. Mean 25OHD levels were 50.4±28 nmol/L. Twelve patients (42.9%) had vitamin D insufficiency, eight (28.6%) had vitamin D deficiency and three (10.7%) had severe deficiency. In conclusion, these results indicated that 53.6% of our chronic PD patients have subnormal bone mass. In addition, vitamin D insufficiency and deficiency are very common in peritoneal dialysis patients.
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Abstract (Original Language): 
Kemik mineral dansitesinin (KMD) düşüklüğü kemik fraktürünün risk faktörlerinden biridir. Kemik fraktürü sıklığı, kronik böbrek yetersizliği olan hastalarda çok yüksektir. Kronik periton diyalizi (PD) hastalarında KMD ile ilgili az sayıda çalışma vardır. Ayrıca, diyaliz hastalarında vitamin D seviyelerindeki düşüklüğün erken mortalite ile ilişkili olduğu ileri sürülmüştür. Biz 28 kronik PD hastasında osteopeni/ osteoporoz sıklığını ve vitamin D seviyeleri ile KMD arasındaki ilişkiyi araştırdık. Kemik dansitesi dual-energy X-ray absorptiometry (DEXA) ile ölçüldü. Kemik kütlesi, Dünya Sağlık Örgütü kriterlerine göre normal, osteopenik ve osteoporotik olarak sınıflandırıldı. Tüm hastalarda serum 25- hidroksivitamin D (25OHD) düzeyleri ölçüldü. Yirmi sekiz hastanın %25.7’sinde osteoporoz, %27.9’unda osteopeni saptandı. Ortalama serum 25OHD seviyeleri 50.4±28 nmol/L idi. On iki (%42.9) hastada vitamin D azlığı, sekiz (%28.6) hastada vitamin D yetersizliği ve üç (%10.7) hastada şiddetli eksiklik tespit edildi. Sonuç olarak, bulgularımız hastalarımızın %53.6’sında kemik kütlesinin subnormal düzeylerde olduğunu göstermektedir. Ayrıca, vitamin D eksikliği ve yetersizliği kronik periton diyalizi hastalarında oldukça sıktır.
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REFERENCES

References: 

1. Jamal SA, Chase C, Goh YI, Rıchardson R, Hawker GA:. Bone
density and heel ultrasound testing do not identify patients with
dialysis-dependent renal failure who had fractures. Am J Kidney
Dis 2002; 39:843–849
2. Atsumi K, Kushida K, Yamazaki K, Shimizu S, Ohmura A, Inoue
T: Risk factors for vertebral fractures in renal osteodystrophy. Am
J Kidney Dis 1999; 33:287–293
3. Coco M, Rush H: Increased incidence of hip fractures in dialysis
patients with low serum parathyroid hormone. Am J Kidney Dis
2000; 36:1115–1121
4. Davison SN: Pain in hemodialysis patients: prevalence, cause,
severity and management. Am J Kidney Dis 2003; 42:1239–1247
5. Ersoy FF, Passadikis SP, Tam P, et al: Bone mineral density and
its correlation with clinical and laboratory factors in chronic
peritoneal dialysis patients. J Bone Miner Metab 2006; 24:79-86
6. Baszko-Blaszyk D, Grzegorzewska AE, Horst-Sikorska W,
Sowinski J: Bone mass in chronic renal insufficiency patients
treated with continuous ambulatory peritoneal dialysis. Adv Perit
Dial 2001; 17:109–113
7. Johnson DW, McIntyre HD, Brown A, Freeman J, Rigby RJ: The
role of DEXA bone densitometry in evaluating renal osteodystrophy
in continuous ambulatory peritoneal dialysis patients. Perit Dial
Int 1996; 16:34-40
8. Passadakis P, Thodis E, Manavis J, Panagoutsos S, Vargemezis V:
The identification of bone mineral density in CAPD in comparison
with HD patients. Adv Perit Dial 1996; 12:247–253
9. Taal MW, Masud T, Gren D, Cassidy MJ: Risk factors for reduced
bone density in hemodialysis patients. Nephrol Dial Transplant
1999; 14:1922–1928
10. Stehman-Breen CO, Sherrard D, Walker A, Sadler R, Alem A,
Lindberg J: Racial differences in bone mineral density and bone
loss among end-stage renal disease patients. Am J Kidney Dis
1999; 33:941–946
11. National Kidney Foundation/KDOQI clinical practice guidelines:
Guideline 7 in bone metabolism and disease in chronic kidney
disease Am J Kidney Dis 2003; 42(4 Suppl.3):1-201
12. Negri AL, Barone R, Quiroga MA, et al: Bone mineral density:
Serum markers of bone turnover and their relationships in
peritoneal dialysis. Perit Dial Int 2004; 24(2):163-168
13. Zitterman A: Vitamin D in preventive medicine: Are we ignoring
the evidence? Br J Nutr 2003; 89:552-572
14. Cunningham J, Makin H: How important is vitamin D deficiency
in uremai? Nephrol Dial Transplant 1997;12:16-18
15. Dawson-Huges B, Heaney RP, Holick MF, et al: Estimates of
optimal vitamin D status. Osteoporosis Int 2005; 16:713-716
16. Stavroulopoulos A, Porter CJ, Roe S, Hosking DJ, Cassidy MJD:
Relationship between vitamin D status, parathyroid hormone
levels and bone mineral density in patients with chronic kidney
disease stages 3 and 4. Nephrology 2008; 13:63-67
17. Wolf M, Shah A, Gutierrez O, et al: Vitamin D levels and early
mortality among incident hemodialysis patients. Kidney Int 2007;
72:1004-1013

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