ISSN:
1440-1797
Quelle:
Blackwell Publishing Journal Backfiles 1879-2005
Thema:
Medizin
Notizen:
SUMMARY: We studied bone histology of 134 uraemic patients without a history of vitamin D administration at the start of haemodialysis. Patients were categorized according to bone histology as follows: aplastic bone disease (ABD), ostitis fibrosa, mixed type, mild hyperparathyroidism and osteomalacia. On initiation of haemodialysis, ABD was observed in 48.5% of patients. the average age of the ABD group (50.8 ± 12.5 years) was significantly higher than that of patients with other histologies (P〈0.01). Serum parathyroid hormone (PTH) and alkaline phosphatase (ALP) concentrations were lower (P〈0.01) in the ABD group, especially in patients with diabetes mellitus. Patients with diabetes mellitus and ABD had lower serum concentrations of PTH and ALP than non-diabetic patients, suggesting that depressed PTH may be related to ABD. Eleven (55%) of the 20 patients who were receiving A1(OH)3 also had ABD. A direct relationship was observed between serum aluminum concentration and aluminum-positive bone surface (r=0.60; P〈0.01). Aluminum staining was more frequently observed in the ABD group than in the non-ABD group (P〈0.01). Because serum intact-PTH concentrations correlate with osteoid surface area, fibrosis volume and bone formation rate, it may be a useful marker of bone histology in renal osteodystrophy. These results suggest that, in addition to conservative treatment with A1(OH)3, other factors may be involved in the formation of ABD which is often present at the start of haemodialysis.
Materialart:
Digitale Medien
URL:
http://dx.doi.org/10.1046/j.1440-1797.1998.d01-21.x
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