Risk factors for renal osteodystrophy: A multivariant analysis
Risk factors for renal osteodystrophy: A multivariant analysis
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肾性骨营养不良的危险因素：多变量分析
DOI：
10.1002/jbmr.5650100121
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发表时间：
1995
影响因子：
6.2
通讯作者：
D. Sherrard
中科院分区：
文献类型：
--
作者：
Y. Pei;G. Hercz;C. Greenwood;G. Segre;A. Manuel;C. Saiphoo;S. Fenton;D. Sherrard
为了评估与肾性骨营养不良相关的危险因素，我们检查了1987年10月至1989年10月在多伦多三个透析中心前瞻性研究的256例患者的数据库。检查的潜在危险因素包括年龄、性别、透析类型和持续时间、磷酸盐结合剂的类型和剂量、维生素D治疗、糖尿病史、同种异体肾移植失败、甲状旁腺切除术和双侧肾切除术。所有患者都进行了骨活检，并被分为四种疾病组之一：(1)纤维性骨炎和混合性骨病，(2)铝质骨病，(3)轻度骨疾病，(4)再生骨疾病。骨活检患者的平均（±SD）年龄为57±15岁，62%为男性。45%的患者接受血液透析治疗，55%接受腹膜透析治疗。透析时间平均为4±4年。25%的人还患有糖尿病。最常见的疾病是再生（或“动态”）骨骼疾病，在34%的患者中发现。27%的患者患有铝质骨病，27%的患者患有纤维性骨炎或混合性骨病，12%的患者患有轻度骨病。铝凝胶的累积摄入与铝骨病相关，而伴有生理钙浓度过高的腹膜透析、碳酸钙摄入和糖尿病与轻度骨障碍和再生骨障碍相关。后三种危险因素可能是通过调节甲状旁腺激素分泌使患者易患低骨转换状态的重要因素。因此，最近透析患者中这些危险因素的频率增加与再生骨疾病的高流行率有关。这种骨疾病的临床意义仍有待确定。
To assess the risk factors associated with renal osteodystrophy, we examined the database of 256 patients who were prospectively studied in three Toronto dialysis centers between October of 1987 and 1989. The potential risk factors examined included age, sex, type and duration of dialysis, type and dose of phosphate binders, vitamin D treatment, and history of diabetes mellitus, renal allograft failure, parathyroidectomy, and bilateral nephrectomy. All patients had undergone a bone biopsy and were categorized into one of four disease groupings: (1) osteitis fibrosa and mixed bone disease, (2) aluminum bone disease, (3) mild bone disorder, and (4) aplastic bone disorder. The mean (±SD) age of the patients at bone biopsy was 57 ± 15 years, and 62% were men. Forty‐five percent of patients were treated by hemodialysis and 55% by peritoneal dialysis. The mean duration of dialysis was 4 ± 4 years. Twenty‐five percent were also diabetic. The most common disorder was the aplastic (or “adynamic”) bone disorder, found in 34% of patients. Aluminum bone disease was found in 27%, osteitis fibrosa or mixed bone disease in 27%, and mild bone disorder in 12% of patients. Cumulative intake of aluminum gels was associated with aluminum bone disease, whereas peritoneal dialysis with supraphysiologic calcium concentrations, ingestion of calcium carbonate, and diabetes mellitus were associated with both mild bone disorder and aplastic bone disorder. These three latter risk factors may be important in predisposing patients to a low bone turnover state through modulation of parathyroid hormone secretion. Thus, recent increases in the frequencies of these risk factors in dialysis patients are associated with a high prevalence of aplastic bone disorder. The clinical significance of this bone disorder remains to be defined.
影响因子：
19.6
作者：
SUGIMOTO, T;RITTER, C;SLATOPOLSKY, E
通讯作者：
SLATOPOLSKY, E
连续不卧床腹膜透析中的矿物质、维生素 D 和甲状旁腺激素。
影响因子：
19.6
作者：
Delmez,JA;Slatopolsky,E;Martin,KJ;Gearing,BN;Harter,HR
通讯作者：
Harter,HR