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DİYALİZE HASTALARDA KEMIK YOĞUNLUĞUNUN TIBIAL ULTRASONOGRAFIK DEĞERLENDIRILMESI

TIBIAL ULTRASOUND EVALUATION OF BONE DENSITY IN DIALYZED PATIENTS

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Abstract (2. Language): 
End stage renal disease (ESRD) patients are at risk of having low bone density (BD) due to disease related and general risk factors. This study was to designed to assess the cortical BD and risk factors, by tibial ultrasound evaluation, in dialysis patients. We included 40 ESRD patients and 37 healthy subjects with matched properties for osteopenia. Tibial ultrasound velocity (TUV) and t score were investigated by Soundscan 2000 device. ESRD patients had lower TUV and t score than control subjects(p=0.001). BD did not change between hemodialysis and continuous ambulatory peritoneal dialysis patients. Serum iPTH levels and dialysis duration negatively correlated with SOS and t scores. No such correlation was found out for age, BMI and heparin exposure. Cortical BD lessens and quality deteriorates increasing probability of fractures in cortical bone in dialysed patients.
Abstract (Original Language): 
Son dönem böbrek yetmezi iMi hastalar(SDBY), hastalığa bağlı ve genel faktörlerin etkisi ile düşük kemik yoğunluğuna (KY) sahip olma riski taşırlar. Bu çalışmada diyaliz hastalarında kortikal KY, tibial ultrasonografik yöntemle değerlendirildi ve ostec neni risk faktörleri araştırıldı. Çalışmaya 40 SDBYli vz 37 sağlıklı kontrol alındı. İki grup genel risk faktörleri açısından homojendi. Tibial ses hızı (SH) ve t skoru Soundscan 2000 cihazı ile değerlendirildi. Bu değerler SDSY'li hastalarda anlamlı olarak düşük bulundu(p=0.001). Hemodializ ve devamlı ayaktan periton diyalizi hastaları arasında SH ve t skoru açısından fark bulunamadı. Serum iPTH ve diyaliz süresi ile bu parametreler arasında negatif korelasyon saptanırken; yaş, vücut kitle indeksi ve heparin kullanımı ile korelasyon saptanmadı. Diyaliz hastalarında kortikal KY ve kemik kalitesi düşüktür, olası kırık riski fazladır.
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REFERENCES

References: 

1. Rix M, Andreassen H, Eskildsen P et al: Bone mineral density and biochemical markers of bone turnover in patients with predialysis chronic renal failure. Kidney International 1999;56:1084-1093.
2. Casajus AS: Utility of bone densimetry in haemodialysis. Nephrol Dial Transplant 1992;7:369.
3. Gabay C, Ruedin P, Slosman D et al: Bone mineral density in patients with end stage renal failure. Am J Nephrol 1993;13:115-123.
4. Lechleitner P, Krimbacher E, Genser N, et al: Bone mineral densitometry in dialyzed patients: quantitative computed tomography versus dual photon absorptiometry. Bone 1994; 15(4):387-91.
5. Stehman-Breen C, Sherrard D, Walker A et al: Racial differences in bone mineral density and bone loss among end stage renal disease patients. Am J Kidney
Dis 1999;33(5):941-946.
6. Jackson J A: Osteoporosis in man. In: Favus MJ (ed),
Primer on the metabolic bone disease and disorders of mineral metabolism Raven Press, New York 1993, pp 255-258.
7. Kanis JA. Osteoporosis. Blackwell Health Care Communications London 1995, pp :22-l 13.
8. Foldes AJ, Rimon A, Keinan DD, et al: Quantitative ultrasound of the tibia: A novel approach for assessment
of bone status. Bone 1995;17(4):363-367.
9. Lee SC, Coan BS, Bouxsein ML: Tibial ultrasound velocity measured insitu predictes the material properties of tibial cortical bone. Bone 1997;21(1):119-125.
10. Stegman MR, Heaney RP, Travers-Gustafson D, et al: Cortical ultrasound velocity as an indicator of bone status. Osteoporosis Int 1995;5:349-353.
11. Baran DT. Quantitative ultrasound: a technique to target women with low bone mass for preventive therapy. Am
J Med 1998;27(2A):48-51.
12. Lequin MH, Van Rijn RR, Robben SG, et al: Evaluation of short-term precision for tibial ultrasonometry. Calcif
Tissue Int 1999;64(l):24-27.
13. Foldes AJ, Arnon E, Popovtzer MM: Reduced speed of sound in tibial bone of hemodialysed patients: association with serum PTH level. Nephrol Dial Transplant 1996;11(7): 1318-1321.
14. Stein MS, Packham DK, Ebeling PR ,et al: Prevalence and risk factors for osteopenia in dialysis patients. Am
J Kidney Dis 1996;28(4):515-522.
15. Mottet JJ, Horber FF, Casez JP, et al: Evidence for preservation of cortical bone mineral density in patients
141
on continuous ambulatory peritoneal dialysis. J Bone
Miner Resl996;l l(l):96-104.
16. Asaka M, Lida H, Entani C, et al: Total and regional bone mineral density by dual photon absorptiometry in patients on maintenance haemodialysis. Clin Nephrol
1992;38(3):149-153.
17. Aguado F, Revilla M, Hernandez ER, et aI:Behaviour of bone mass measurements. Dual energy absorptiometry total body bone mineral content, ultrasound bone velocity and computed metacarpal radiogrammetry, with age, gonadal status, and weight in
healthy women. Inu-M Radiol 1996;31(4):218-222.
18. Piraino B, Chen T, Cooperstein L, et al: Fractures and vertebral bone mineral density in patients with renal
osteodystrophy. Clin Nephrol 1988;30(2):57-62.
19. Heaf JG, Nielsen LP, Mogensen NB: Use of bone
mineral content determination in the evaluation of osteodistrophy among haemodialysis patients. Nephron 1983;35:103-107.
20. Boling E, Primavera C, Friedman G, et al: Non invasive measurements of bone mass in adult renal
osteodistrophy. Bone 1993;14:409-413.
21. Copley JB, Hui SL, Leapman S et al: Longitudinal study of bone mass in end stage renal disease patients: Effects of parathyroidectomy for renal osteodistrophy. J
Bone Miner Res 1993;8(4):415-422.
22. Walker RD: Renal functional changes associated with vesicoureteral reflux. Urologic Clinics of North
America 1990;17(2):307-316.
142

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