Histological, radiological, and biochemical features of the adynamic bone lesion in continuous ambulatory peritoneal dialysis patients.
Histological, radiological, and biochemical features of the adynamic bone lesion in continuous ambulatory peritoneal dialysis patients.
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连续不卧床腹膜透析患者骨损伤的组织学、放射学和生化特征。
DOI：
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发表时间：
1994
影响因子：
4.2
通讯作者：
R. Gokal
中科院分区：
文献类型：
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作者：
A. Hutchison;R. Whitehouse;A. Freemont;Judy E. Adams;B. Mawer;R. Gokal
动态骨在透析患者中出现的频率越来越高。人们对其病因知之甚少，对其自然史的了解就更少了。我们在32例连续门诊腹膜透析患者中发现10例无症状动态骨，其中大多数患者从未接触过含铝磷酸盐结合剂。与其余22例患者相比，他们的平均年龄更大（54 +/- 11.4岁对42 +/- 11.8岁，p < 0.05），透析前肾功能衰竭持续时间可能更长（10.9年对7.1年），平均离子钙较高（1.30 +/- 0.04比1.15 +/- 0.02 mmol/l, p < 0.01），平均完整甲状旁腺激素较低（31.5比200.3 pg/ml, p < 0.001）。两组骨密度差异无统计学意义，但10例动态组中有9例有明显的血管钙化，而对照组20例中仅有7例（p < 0.05）。动态患者的随访显示其与血清完整甲状旁腺激素和离子钙水平密切相关。除了一个例外，与其他类型的骨营养不良相比，动态骨似乎与较低的骨密度无关，但需要更长期的研究来确定这种病变的完整自然历史。
Adynamic bone is being found with increasing frequency in dialysis patients. Little is known about its aetiology, and even less about its natural history. We found 10 cases of asymptomatic adynamic bone among a group of 32 continuous ambulatory peritoneal dialysis patients, most of whom had never been exposed to aluminium-containing phosphate binders. Compared to the remaining 22 patients, they had an older mean age (54 +/- 11.4 vs. 42 +/- 11.8 years; p < 0.05), probably a longer pre-dialysis duration of renal failure (10.9 vs. 7.1 years), higher mean ionized calcium (1.30 +/- 0.04 vs. 1.15 +/- 0.02 mmol/l; p < 0.01), and lower mean intact parathyroid hormone (31.5 vs. 200.3 pg/ml; p < 0.001). The bone density was not different between the two groups, but 9 of the 10 adynamic patients had significant vascular calcification seen on plain radiology as compared with only 7 of 20 in the comparison group (p < 0.05). Follow-up of the adynamic patients showed a close association with serum intact parathyroid hormone and ionized calcium levels. With one exception, adynamic bone did not appear to be associated with lower bone density than other types of osteodystrophy, but a longer-term study is required to determine the complete natural history of this lesion.