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[慢性血液透析患者的肾性骨营养不良及其可能的纠正方法]

[Renal osteodystrophy and its possible correction in patients on chronic hemodialysis].

作者信息

Rozental' R L, Babarykin D A, Tikhomirova T E, Il'inskiĭ I M, Chernevskis Kh K

出版信息

Ter Arkh. 1986;58(1):105-8.

PMID:3961679
Abstract

Results of diagnosis and treatment of renal osteodystrophy are discussed concerning 162 patients with chronic renal failure treated by hemodialysis. In most cases (15%) osteopenia and hyperparathyroidism were revealed. Roentgenologic investigation revealed metastatic calcification mostly in foot vessels, whereas microscopic study of internal organs in the lungs. The increase of calcium concentration in dialysate from 1.75 to 2.5 Mmol/l was not followed by greater calcinosis in patients with hyperphosphatemia. Uremic pruritus was treated by ultraviolet irradiation and administration of prednisolone for 3-5 days. The effect of I alpha-hydroxy-vitamin D3 was studied in 30 patients. Improvement of clinical status and, principally, relief of muscular pains in the extremities was observed as well as positive changes in blood serum biochemical indices.

摘要

本文讨论了162例接受血液透析治疗的慢性肾衰竭患者肾性骨营养不良的诊断和治疗结果。大多数病例(15%)显示有骨质减少和甲状旁腺功能亢进。X线检查发现转移性钙化主要位于足部血管,而肺部等内脏器官的显微镜检查也有发现。对于高磷血症患者,将透析液中钙浓度从1.75mmol/L提高到2.5mmol/L后,并未出现更严重的钙化。采用紫外线照射和给予泼尼松龙3 - 5天来治疗尿毒症瘙痒。对30例患者研究了1α-羟基维生素D3的疗效。观察到临床状况有所改善,主要是四肢肌肉疼痛得到缓解,同时血清生化指标也出现了积极变化。

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