Avtor/Urednik		Pečovnik-Balon, Breda; Rajšp, Primož; Soršak, Andrej
Naslov		Pomen merjenja kostne gostote pri bolnikih s kronično ledvično boleznijo
Prevedeni naslov		Significance of measuring bone mineral density in patients with chronic kidney disease
Tip		članek
Vir		In: Novosti v osteologiji : monografija III. Osteoloških dnevov z mednarodno udeležbo, 21. in 22. oktober 2011, Medicinska fakulteta Univerze v Mariboru Maribor : Univerzitetni klinični center
Leto izdaje		2011
Obseg		str. 119-127
Jezik		slv
Abstrakt		Izhodišča: Pri bolnikih s kronično ledvično boleznijo (KLB) pogosto pride do spremenjenega kostnega metabolizma, znižane mineralne kostne gostote (MKG) in zlomov. Namen raziskave je bil oceniti MKG pri bolnikih zdravljenih s hemodializo (HD), kako se MKG spreminja s časom (deltaMKG) in opredeliti dejavnike, povezane s tem. Metode: V prospektivno klinično študijo je bilo vključenih 47 bolnikov zdravljenih s HD. S pomočjo denzitometra Explorer smo izmerili MKG v predelu vratu leve stegnenice (VS), celotnega kolka (CK) in ledvene hrbtenice (LH) in ponovili merjenje po povprečno 20,9 +/- 4,5 mesecih. Rezultati: T-vrednosti MKG manjše kot -1 SD po predelih VS, CK, LH je imelo 67%, 64% in 50% bolnikov. T-vrednosti MKG nižje od -2,5 SD je imelo v istih predelih 27%, 16% oz. 22% bolnikov. Ugotovljena je bila pozitivna korelacija med MKG v predelu LH in težo bolnikov (p=0,009) in negativna korelacija med starostjo bolnikov in MKG v predelu VS (p=0,017). Povprečne vrednosti intaktnega parathormona (iPTH) so pozitivno korelirale z deltaMKG v predelu LH (Rho=0,36; p=0,015), kot tudi v predelu CK (Rho=0,49; p=0,001). Ugotovili smo značilno poslabšanje MKG v predelu LH pri skupini bolnikov z iPTH < 100 pg/ml. Zaključki: MKG v predelu VS in CK je bila nižja kot v predelu LH. Starost in teža sta bila napovednika MKG. Znižanje MKG je bilo največje pri bolnikih z iPTH <100 pg/ml.Background: End-stage renal disease is often associated with altered bone metabolism, low bone mass and skeletal fragility. The purpose of this study was to determine bone mineral density (BMD), how BMD is changing in time and factors associated with BMD. Methods: 47 subjects undergoing HD treatment were included in this prospective clinical study. We measured BMD at left femoral neck (FN), total hip (TH) and at lumbar spine (LS) and repeated measurement after 20,9 +/- 4,5 months using a Explorer densitometers - a third generation of densitometers based on dual-energy X-ray absorptiomentry (DXA). Results: Using WHO criteria as a cutoff point, in the first measurement of BMDT-score lower than -1 was found in 67% of patients at FN, 64% at TH and 50% at LS. T-score lower than -2,5 was found in 27%, 16% and 22%, respectively. We have found a positive correlation between BMD at LS and weight (p=0,009) and a negative correlation between age and BMD at FN (p=0,017). PTHi correlated positively with longitudinal changes in BMD at LS (Rho=0,36; p=0,015) and TH (Rho=0,49; p=0,001). There was significant decrease in BMD at LS in patients with PTHi < 100 pg/ml. Conclusions: BMD was lower at FN and TH than at LS. Higher age, lower body weight were associated with lower BMD. The decrease in BMD was highest in patients with PTHi <100 pg/ml.
Deskriptorji		Kidney Failure, Chronic Ledvična odpoved, kronična Bone Density Kostna gostota Renal Dialysis Renalna dializa Risk Factors Dejavniki tveganja