Kokot F, Zazgornik J, Pietrek J, Schmidt P, Fürst K, Czembirek H, Kopsa H
Z Gesamte Inn Med. 1978 Aug 1;33(15):516-20.
In 40 renal transplant patients the serum concentration of parathyroid hormone, 25-hydroxycholecalciferol, calcium and inorganic phosphate were estimated. The results of these biochemical studies were compared to X-ray soft tissue and bone pathologic findings. The serum immunoreactive parathyroid hormone (iPTH) was normal in 37 patients and increased in 3 cases. 19 (47.5%) renal transplant recipients showed decreased serum 25-hydroxycholecalciferol levels. In 23 out of 40 patients (57.5%) serum phosphate was lower than 3.0 mg/100 ml. X-ray soft tissue changes were observed in 28 (70%) and bone changes in 18 (45%) patients; both frequencies were higher when compared to occurrence during regular dialysis treatment. Features of hyperparathyroid osteopathy were frequently observed in renal transplant recipients. Femoral head necroses were predominant in men, whereas osteomalacia with Looser's zones were found mainly in women. The pathogenesis of X-ray bone changes in patients with renal transplants seems to be multifactorial and related to the duration of secondary hyperparathyroidism before renal transplantation as well as to phosphate depletion and 25-hydroxycholecalciferol deficiency.
对40例肾移植患者的甲状旁腺激素、25-羟胆钙化醇、钙和无机磷的血清浓度进行了测定。将这些生化研究结果与X线软组织及骨骼病理检查结果进行了比较。37例患者血清免疫反应性甲状旁腺激素（iPTH）正常，3例升高。19例（47.5%）肾移植受者血清25-羟胆钙化醇水平降低。40例患者中有23例（57.5%）血清磷低于3.0mg/100ml。28例（70%）患者观察到X线软组织改变，18例（45%）患者有骨骼改变；与常规透析治疗期间的发生率相比，这两个频率都更高。肾移植受者中经常观察到甲状旁腺功能亢进性骨病的特征。股骨头坏死在男性中占主导地位，而伴有假骨折线的骨软化症主要见于女性。肾移植患者X线骨改变的发病机制似乎是多因素的，与肾移植前继发性甲状旁腺功能亢进的持续时间以及磷缺乏和25-羟胆钙化醇缺乏有关。
