Increased incidence of hip fractures in dialysis patients with low serum parathyroid hormone
Increased incidence of hip fractures in dialysis patients with low serum parathyroid hormone
复制标题
DOI：
10.1053/ajkd.2000.19812
复制
发表时间：
2000-12-01
影响因子：
13.2
通讯作者：
Rush, H
中科院分区：
文献类型：
--
作者：
Coco, M;Rush, H
为了研究终末期肾病患者肾性骨营养不良的并发症，我们回顾了1988-1998年间我们门诊透析人群中髋部骨折的发生率。1,272名患者总共接受了4,039个病人年的治疗；在此期间记录了56个髋部骨折。在每个年龄、种族和性别匹配的亚组中，透析患者的髋部骨折发生率是普通人群的数倍。与普通人群相比，透析患者因髋部骨折事件导致的一年死亡率几乎高出2.5倍。在这十年的前五年，髋部骨折的发生率与在后五年观察到的相似。当评估甲状旁腺激素水平时，我们确定血清甲状旁腺激素水平较低的患者比甲状旁腺激素水平较高的患者更容易发生髋部骨折(P<；0.006)。此外，我们确定PTH水平较低的患者比PTH水平较高的患者有更早的死亡率(P<；0.03)。我们的结论是，尽管近年来我们的透析患者在骨健康方面进行了更积极的治疗，但髋部骨折的发生率及其破坏性的发病率和死亡率在过去十年中保持不变。较低的甲状旁腺素水平可能更容易导致早期死亡。(C)2000年，由国家肾脏基金会公司提供。
To study the complications of renal osteodystrophy in patients with end-stage renal disease, we reviewed the incidence of hip fractures in our outpatient dialysis population from 1988 to 1998. One thousand two hundred seventy-two patients were treated for a total of 4,039 patient-years; 56 hip fractures were documented during this period. The incidence of hip fractures was many times greater in the dialysis patients than in the general population in each of the age-, race-, and sex-matched subgroups. The 1-year mortality rate from the hip fracture event was nearly two and a half times greater in the dialysis patients compared with the general population. The incidence of hip fractures in the first half of the decade was similar to that observed in the second half. When parathyroid hormone (PTH) levels were evaluated, we determined that patients with lower serum PTH levels were more likely to sustain a hip fracture than patients with higher PTH levels (P < 0.006). In addition, we determined that patients with lower PTH levels had an earlier mortality than patients with higher PTH levels (P < 0.03). We conclude that despite more aggressive therapy directed toward bone health in our dialysis patients in recent years, the incidence of hip fractures and their devastating morbidity and mortality remained unchanged over the past decade. Lower PTH levels may predispose to earlier mortality. (C) 2000 by the National Kidney Foundation, Inc.