巴西东北部透析患者样本中的肾性骨营养不良：一项横断面分析。
Renal osteodystrophy in a sample of patients on dialysis in Northeastern Brazil: a cross-sectional analysis.
作者信息
Coutinho Luiz Alberto Soares de Araújo, Gueiros Ana Paula Santana, Vaz Júlia Braga, Russo Eduarda Cerqueira, Jorgetti Vanda, Gueiros José Edevanilson de Barros
机构信息
Universidade Federal de Pernambuco, Empresa Brasileira de Serviços Hospitalares, Hospital das Clínicas, Serviço de Nefrologia, Recife, PE, Brazil.
Universidade de São Paulo, Faculdade de Medicina, Laboratório de Investigação Médica, São Paulo, SP, Brazil.
出版信息
J Bras Nefrol. 2025 Apr-Jun;47(2):e20240174. doi: 10.1590/2175-8239-JBN-2024-0174en.
INTRODUCTION
Mineral and bone meta-bolism disorders in chronic kidney disease (CKD-MBD) are one of the most significant complications of CKD. The objective of this study was to describe the types of renal osteodystrophy (ROD) and the clinical and osteometabolic profiles of dialysis patients undergoing bone biopsy in Pernambuco.
METHODS
A cross-sectional, retrospective study that assessed patients biopsied between January 2004 and September 2021 was conducted. Patients receiving conservative treatment for CKD, kidney transplant recipients, and those with inadequate biopsies were excluded. All clinical and laboratory parameters were from the time of biopsy.
RESULTS
We assessed 250 patients with median age of 48 years (57.6% women) and on dialysis for a median time of 108 months. Regarding the diagnosis of ROD, the prevalence was: osteitis fibrosa (54.5%), mixed disease (30.4%), adynamic bone disease (12.4%), and osteomalacia (3.2%). The prevalences of osteoporosis, aluminum toxicity, and iron toxicity were 43.6%, 46.8% and 27.5%, respectively.
CONCLUSIONS
We demonstrated a high prevalence of diseases related to high bone turnover and aluminum toxicity.
引言
慢性肾脏病矿物质和骨代谢紊乱（CKD-MBD）是慢性肾脏病最严重的并发症之一。本研究的目的是描述在伯南布哥州接受骨活检的透析患者的肾性骨营养不良（ROD）类型以及临床和骨代谢特征。
方法
进行了一项横断面回顾性研究，评估了2004年1月至2021年9月间接受活检的患者。排除接受慢性肾脏病保守治疗的患者、肾移植受者以及活检不充分的患者。所有临床和实验室参数均来自活检时。
结果
我们评估了250例患者，中位年龄为48岁（女性占57.6%），透析中位时间为108个月。关于ROD的诊断，患病率分别为：纤维性骨炎（54.5%）、混合性疾病（30.4%）、动力缺失性骨病（12.4%）和骨软化症（3.2%）。骨质疏松症、铝中毒和铁中毒的患病率分别为43.6%、46.8%和27.5%。
结论
我们证明了与高骨转换和铝中毒相关疾病的高患病率。
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