Rics factors for reduced bone density in haemodialysis patients

Hemodiyaliz hastalarında kemik mineral yoğunluğunda azalmaya neden olabilen risk faktörleri

Abstract

Risk factors for reduced bone density in haemodialysis patients.Haemodialysis patients are likely to have low bone mineral density (BMD) due to a combination of several alterations in bone and mineral metabolism. We investigated the prevalance of reduced BMD and its association with age, sex, body mass index, duration of dialysis, calcium and phosphorus levels, alkaline phosphatase, heparin dose, erythropoietin, serum ferritin, haemoglobin, urea reduction ratio (%), intact parathyroid hormone (PTH) and calcium (mg/day) and alphacalcidiol supplement. The study population involved 35 patients on chronic hemodialysis (female/male=16/19, mean age=49.6 $pm$ 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 score of between -1.0 and -2.5 and osteoporosis as $qeg$2.5. Statistical analysis were performed using Pearson's correlation coefficients. In 24 patients (69 %), LS and/or FN-BMD were more than 1 SD below young adult mean value. Mean values ($pm$SD): LS-BMD (T score): -2.17 ± 1.47; FN-BMD (T-score): -1.15 $pm$ 1.55; PTH: 266.5 ± 420.6 pg/dL; AP: 138.6 ± 90.4 U/L; calcium: 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

Özet

Hemodiyaliz hastalarında kemik ve mineral metabolizmasındaki bazı değişikliklere bağlı olarak kemik mineral yoğunluğu (KMY) azalmaktadır. Azalmış KMY prevalansmı ve bu azalma-nın yaş, cinsiyet, beden kitle indeksi (BKİ), diyaliz süresi, kalsiyum ve fosfor düzeyleri, alkalen fosfataz, heparin dozu, eritropotein, serum ferritin, hemoglobin, üre azalma oranı(%), intakt parathormon(PTH), kalsiyum ve alfakalsidiol takviyesi ile ilişkisini araştırdık. 35 kronik hemodiyaliz hastasında (K/E:16/19; ortalama yaş: 49.6$pm$16.2) KMY lomber vertebra (LV) ve femur boynundan (FB) dual-enerji X-ray absorpsiyometri (DEXA) yöntemiyle ölçüldü. İstatistiksel analizler Pearson korelasyon katsayısı ile yapıldı. 24 hastada (%69), LV ve/veya FB-KMY genç erişkin oratalama değerinden 1SD daha düşüktü. Ortalama değerler ($pm$SD): LV-KMY(T skoru): -2.17±1.47; FB-KMY(T skoru): -1.15 $pm$ 1.55; PTH: 266.5 ± 420.6 pg/dL; AP:138.6(90.4 $mu$/L; kalsiyum:9.8 ± 0.9 mg/dL; fosfor: 5.1 ± 1.4 mg/dL bulundu. Yaş ile FB-KMY(r=-0.55, p