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在维持血液透析的患者中骨折的发生率
Abdullah Kashgary1, Feryal Omar A Attiah2, Nada AbuBakr AlKhateeb2
1Department of Medicine, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.
Renal failure
|June 22, 2023
概括
接受血液透析 (HD) 的患者面临高骨折风险. 较高的骨特异性酸酶 (BSAP) 水平,骨质疏松症和更长的HD持续时间是这些患者骨折发生率的关键预测因素.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 内分泌学 在内分泌学.
- 整形外科 整形外科 整形外科
背景情况:
- 患有慢性病 (CKD) 的患者,特别是接受血液透析 (HD) 的患者,患有脆弱性骨折的风险较高.
- 在沙特阿拉伯这个人口中,特定的风险因素和骨折的发生率仍未得到充分研究.
研究的目的:
- 调查在沙特阿拉伯吉达接受血液透析的成年患者中骨折的发生率和危险因素.
- 确定HD患者队列中骨折发展的关键预测因素.
主要方法:
- 从2015年到2021年,在吉达的HD中心进行了一项多中心的回顾性研究.
- 收集了来自328名成年HD患者的数据,包括人口统计,药物和临床/生化参数.
- 使用注册记录分析了骨折发生率和相关的风险因素.
主要成果:
- 该研究包括328名HD患者 (平均年龄53岁;中位数HD持续时间47个月).
- 在32名患者中发生骨折,发病率为20例/1000个末期病患者年.
- 骨折的重大风险因素包括骨质疏松症,先前的甲状腺切除术,更长的HD复古和骨特异性性酸酶 (BSAP) 水平的升高.
- BSAP是最强的预测因素,截止值为96.6μg/L,显示81.8%的灵敏度和49%的骨折预测特异性.
结论:
- 骨质疏松症,副甲状腺切除术,长时间的HD持续时间和高的BSAP水平是HD患者骨折的主要危险因素.
- 较高的BSAP水平是发生骨折的最重要的预测因素,这强调了监测骨循环标志物的重要性.
- 高骨周转率会对患者健康产生负面影响,需要针对性干预和对患有慢性瘤的患者进行监测.
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