The evaluation of renal osteodystrophy in patients on hemodialysis by biochemical and radiological methods

AYLI, Deniz; ÜNLÜ AKYÜZ, ECE; MANDIROĞLU, SİBEL

The evaluation of renal osteodystrophy in patients on hemodialysis by biochemical and radiological methods

Sibel MANDIROĞLU, (SB Ankara Fizik Tedavi ve Rehabilitasyon Eğitim Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Ankara, Türkiye)

ECE ÜNLÜ AKYÜZ, (SB Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, Ankara, Türkiye)

Deniz AYLI (SB Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Nefroloji Kliniği, Ankara, Türkiye)

Türk Osteoporoz Dergisi

3 0

Yıl: 2013 Cilt: 19 Sayı: 1 Sayfa Aralığı: 7 - 11 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

The evaluation of renal osteodystrophy in patients on hemodialysis by biochemical and radiological methods

Öz:

Amaç: Bu çalışmada kronik böbrek yetmezliği olan olgularda renal osteodistronin erken tanısında faydalı olabilecek radyolojik ve biyokimyasal parametreleri prospektif olarak araştırmayı planladık. Gereç ve Yöntem: Kronik böbrek yetmezliği nedeni ile hemodiyalize giren 50 olgu ve dahil edildi. Böbrek problemi ve kemik hastalığı olmayan 50 olgu kontrol grubu olarak çalışmaya dahil edildi. Serum kalsiyum, fosfor, alkalen fosfataz,β−microglobulin (βm), osteokalsin (BGP), intact parathormon (iPTH) seviyeleri ölçüldü.Her iki grupta sağ el graleri magniye teknikle çekildi. Lomber vertebra ve femur boyun kemik mineral yoğunluğu (KMY) DEXA yöntemi ile ölçüldü. Bulgular: Olgularımızın ortalama hastalık süresi 8,38±5,61 yıl, diyalize girme süresi 6,9±4,01 yıldı. Kalsiyum dışındaki bütün biyokimyasal parametlerde olgu ve kontrol grubumuz arasında önemli derecede fark mevcuttu (p<0,05).İPTH ve KMY arasında negatif korelasyon mevcuttu (r=-0,4, p<0,05). İPTH ve BGP, İPTH ve β2 m arasında pozitif korelasyon mevcuttu (r=0,6, p<0,05), (r=0,5, p<0,05). Diyaliz süresi ve femur boyun KMY arasında istatistiksel olarak anlamlı, düşük düzeyde negatif korelasyon mevcuttu (r=0,2,p<0,05). Diyaliz süresi ve İPTH, diyaliz süresi ve βm arasında pozitif korelasyon mevcuttu (r=0,3, p<0,05),(r:0.4, p<0,05).El gralerinde osteopeni ve subperiostal resorbsiyon, radyal arter kalskasyonu ve endosteal resorbsiyon görüldü. Olgularımızın %80’de osteopeni, %58’de subperiostal resorbsiyon saptandı. İPTH seviyesi 200 pg/ml üzerinde olan olgular ve osteopenisi olan olgularda RO tanısı için sensitivite %93, spesite %92’dü. Yüksek İPTH-BGP için sensitivite ve spesite sırası ile %90,3 ve %87 ‘di. Yüksek İPTH-subperiostal resorbsiyon için ise sensitivite %83,9, spesite %84,2 ‘di. Sonuç: İPTH, BMD, BGP ölçümleri ve el gralerinin değerlendirilmesi RO‘nin erken tanısı ve izleminde kullanılabilir. (Türk Osteoporoz Dergisi olan olgular ve osteopenisi olan olgularda RO tanısı için sensitivite %93, spesite %92’dü. Yüksek İPTH-BGP için sensitivite ve spesite sırası ile %90,3 ve %87 ‘di. Yüksek İPTH-subperiostal resorbsiyon için ise sensitivite %83,9, spesite %84,2 ‘di. Sonuç: İPTH, BMD, BGP ölçümleri ve el gralerinin değerlendirilmesi RO‘nin erken tanısı ve izleminde kullanılabilir. (Türk Osteoporoz Dergisi

Anahtar Kelime:

Konular: Genel ve Dahili Tıp

Hemodiyaliz hastalarında renal osteodistrofinin radyolojik ve biyokimyasal yöntemlerle değerlendirilmesi

Öz:

Aim: We planned this study in order to evaluate the radiological and biochemical parameters that may be useful in the early diagnosis of renal osteodystrophy in the patients with chronic renal failure, prospectively. Meterial and Methods: In this study, 50 cases on hemodialysis due to chronic renal failure were included and 50 cases without renal and bone pathology were included as control group. Serum levels of calcium, phosphate, alkalen phosphatase, βm, osteocalcin (BGP) and intact parathormon (iPTH) were measured. Right hand graphies of both case and control groups were taken by magnifying techniques. Bone mineral densities (BMD) of lumbar vertebra and femur neck were calculated by DEXA method. Results: The average disease duration and the average of duration of hemodialysis of cases were 8.38±5.61years and 6.9±4.01years, respectively. There were signicant differences between case and control groups in all biochemical parameters, except calcium levels (p<0.05). There were a negative correlation between iPTH and BMD (r=-0.4, p<0.05), and pozitif correlations between iPTH and BGP (r=0.6, p<0.05), and between PTH and β-m (r=0.5, p<0.05). A low level negative but statistically signicant correlation between dialysis duration and femur neck bone mineral density was determined (r=0.2, p<0.05). There were positive correlations between dialysis duration and PTH levels (r:0.3, p<0.05), and between dialysis duration and β2 m (r=0.4, p<0.05). In the hand graphies, osteopenia, subperiostal resorption, radial artery calcication and endoosteal resorption were seen. Ostepenia was determined in 80% of our cases, however, subperiostal resorption was found in 58% of patients. The cases that had iPTH levels over than 200 pg/ml and cases that have osteopenia have sensitivity of 93% and spesity of 92% for RO diagnosis. Sensitivity and spesity for high iPTH-BGP levels were 90.3% and 87%, respectively. Sensitivity and spesity in the evaluation of high iPTH-subperiostal resorption were 83.9% and 84.2%, respectively. Conclusion: Measure of iPTH, BMD, BGP and evaluation of hand graphies may be used in early diagnosis and follow-up of RO.

Anahtar Kelime:

Konular: Genel ve Dahili Tıp

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	MANDIROĞLU S, ÜNLÜ AKYÜZ E, AYLI D (2013). The evaluation of renal osteodystrophy in patients on hemodialysis by biochemical and radiological methods. , 7 - 11.
Chicago	MANDIROĞLU SİBEL,ÜNLÜ AKYÜZ ECE,AYLI Deniz The evaluation of renal osteodystrophy in patients on hemodialysis by biochemical and radiological methods. (2013): 7 - 11.
MLA	MANDIROĞLU SİBEL,ÜNLÜ AKYÜZ ECE,AYLI Deniz The evaluation of renal osteodystrophy in patients on hemodialysis by biochemical and radiological methods. , 2013, ss.7 - 11.
AMA	MANDIROĞLU S,ÜNLÜ AKYÜZ E,AYLI D The evaluation of renal osteodystrophy in patients on hemodialysis by biochemical and radiological methods. . 2013; 7 - 11.
Vancouver	MANDIROĞLU S,ÜNLÜ AKYÜZ E,AYLI D The evaluation of renal osteodystrophy in patients on hemodialysis by biochemical and radiological methods. . 2013; 7 - 11.
IEEE	MANDIROĞLU S,ÜNLÜ AKYÜZ E,AYLI D "The evaluation of renal osteodystrophy in patients on hemodialysis by biochemical and radiological methods." , ss.7 - 11, 2013.
ISNAD	MANDIROĞLU, SİBEL vd. "The evaluation of renal osteodystrophy in patients on hemodialysis by biochemical and radiological methods". (2013), 7-11.

APA	MANDIROĞLU S, ÜNLÜ AKYÜZ E, AYLI D (2013). The evaluation of renal osteodystrophy in patients on hemodialysis by biochemical and radiological methods. Türk Osteoporoz Dergisi, 19(1), 7 - 11.
Chicago	MANDIROĞLU SİBEL,ÜNLÜ AKYÜZ ECE,AYLI Deniz The evaluation of renal osteodystrophy in patients on hemodialysis by biochemical and radiological methods. Türk Osteoporoz Dergisi 19, no.1 (2013): 7 - 11.
MLA	MANDIROĞLU SİBEL,ÜNLÜ AKYÜZ ECE,AYLI Deniz The evaluation of renal osteodystrophy in patients on hemodialysis by biochemical and radiological methods. Türk Osteoporoz Dergisi, vol.19, no.1, 2013, ss.7 - 11.
AMA	MANDIROĞLU S,ÜNLÜ AKYÜZ E,AYLI D The evaluation of renal osteodystrophy in patients on hemodialysis by biochemical and radiological methods. Türk Osteoporoz Dergisi. 2013; 19(1): 7 - 11.
Vancouver	MANDIROĞLU S,ÜNLÜ AKYÜZ E,AYLI D The evaluation of renal osteodystrophy in patients on hemodialysis by biochemical and radiological methods. Türk Osteoporoz Dergisi. 2013; 19(1): 7 - 11.
IEEE	MANDIROĞLU S,ÜNLÜ AKYÜZ E,AYLI D "The evaluation of renal osteodystrophy in patients on hemodialysis by biochemical and radiological methods." Türk Osteoporoz Dergisi, 19, ss.7 - 11, 2013.
ISNAD	MANDIROĞLU, SİBEL vd. "The evaluation of renal osteodystrophy in patients on hemodialysis by biochemical and radiological methods". Türk Osteoporoz Dergisi 19/1 (2013), 7-11.