Modificări biochimice în patologia osteo-articulară la pacienţii cu boala cronică de rinichi stadiul V sub hemodializă

Abstract

Summary. The objective of the study was to determine the biochemical changes in mineral metabolism and bone disease in hemodialysis (HD) patients and determine risk factors that may influence their disorder, as well as the clinical practices for bone disease control in relation to the laboratory targets recommended in the National kidney Foundation Dialysis Outcomes Quality Initiative (kDOQI) guidelines. The mean values for calcium were 2,28 ± 0.37 mmol/l, phosphorus 2.13 ± 0.37 mmol/l, intact PTH (iPTH) 386 ± 365 pg/ml, Ca X P 4,91 ± 1,1 mmol2 /l2, total alkalin phosphathase (tAP) 292,39±174,9 UI. Hypocalcemia (<2,1mmol/l) was present in 37.9% of patients, whereas 7.4% of patients presented hypercalcemia (>2,4mmol/l). Hyperphosphoremia (>1,8mmol/l) was present in 52.4% of patients. Ca X P was <4,5 mmol2/l2 in 73% of patients. Thirty nine percent of patients presented secondary hyperparathyroidism (HPTH >300 pg/ml), being severe in 12% (>600 pg/ml); 30,4% of patients presented iPTH <150 pg/ml. Only 30,4% of patients achieved the four recommendations provided in the kDOQI guidelines. Vitamin D treatment was not administered in patients. 54,7% of patients achieved targets based on the clinical recommendations of the kDOQI guidelines for calcium, 47,6% for phosphorus, 73% for Ca X P and 30,6% for iPTH levels in our study.