高钙透析液在肾性骨软化症治疗中的应用。

The use of high calcium dialysate in the treatment of renal osteomalacia.

作者信息

Evans R A, Somerville P J

出版信息

Aust N Z J Med. 1976 Feb;6(1):10-5. doi: 10.1111/j.1445-5994.1976.tb03284.x.

DOI:10.1111/j.1445-5994.1976.tb03284.x

Abstract

Four chronic haemodialysis patients suffering from osteomalacia were treated by increasing their dialysate calcium concentration from 1-40 to 2-15 mM/I. Bone biopsies were taken before and after 22 weeks of this treatment and a further biopsy was taken in one patient after 52 weeks. Symptomatic cure occurred in one patient with mild osteomalacia and some improvement osteomalacia and hyperparathyroidism. Bone biopsies showed slight improvement in the patient with mild osteomalacia after 22 weeks, and considerable improvement after 25 weeks. In the patient with mixed histology, the osteitis fibrosa subsided and the osteomalacia became a little worse after 22 weeks. There was no histologic improvement in the two patients with severe osteomalacia after 22 weeks. It is concluded that high calcium dialysis is not an effective treatment for renal osteomalacia.

摘要

4例患有骨软化症的慢性血液透析患者接受了治疗，方法是将透析液钙浓度从1.40mmol/L提高到2.15mmol/L。在该治疗22周前后进行了骨活检，并且在1例患者52周后又进行了一次活检。1例患有轻度骨软化症的患者症状得到治愈，另外一些患者的骨软化症和甲状旁腺功能亢进有所改善。骨活检显示，轻度骨软化症患者在22周后有轻微改善，25周后有显著改善。在组织学表现混合的患者中，骨纤维炎在22周后消退，但骨软化症稍有加重。2例患有严重骨软化症的患者在22周后组织学上没有改善。结论是高钙透析不是治疗肾性骨软化症的有效方法。