在接受血液透析的患者中,在denosumab后持续的低酸血症
Ahmed A S Almodares1, Grahame J Elder2, Bo Abrahamsen3
1Department of Medicine 1 - Endocrinology- Nephrology and Cardiology, Holbæk Hospital, Holbæk, Denmark.
Bone
|February 10, 2024
概括
在透析患者中,德诺苏马布治疗可能会导致严重的低血和低血,即使没有高骨周转率. 在开始这种人群的德诺苏马布治疗之前,建议仔细监测骨周转和酸盐水平.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 内分泌学 在内分泌学.
- 骨的新陈代谢 骨的新陈代谢
背景情况:
- 接受血液透析 (HD) 的患者有患骨病的风险.
- 严重的骨质疏松症和骨折在患有慢性病的患者中很常见.
- 德诺苏马布是一种用于治疗骨质疏松症的骨质再吸收抑制剂.
研究的目的:
- 报告在接受血液透析的患者中,在denosumab治疗后出现严重的低酸盐血症和低血症病例.
- 为了突出代诺苏马布在透析患者的潜在风险,无论骨周转标志物.
- 建议在患有功能衰竭的患者中谨慎对待德诺苏马布治疗.
主要方法:
- 一个81岁的男性接受血液透析,患有严重骨质疏松症,接受了denosumab治疗的病例报告.
- 在服用登苏马布后监测血清酸盐和水平.
- 在这种情况下,审查潜在的低度血和低度血机制.
主要成果:
- 患者在开始服用德诺苏马布两周后出现严重的低血 (0.11 mmol/L) 和低血 (电离0.83 mmol/L).
- 需要输入静脉酸盐输液,患者在三个月后继续服用酸盐补充剂.
- 尽管缺少高骨周转标志物,但这种情况仍然发生.
结论:
- 透析患者,即使没有高骨周转率,在denosumab治疗中也面临严重低血和低血的风险.
- 酸盐吸收受损或沉积增加可能会导致这些不良事件.
- 在开始为透析患者治疗前,对骨周转和血清酸盐水平的治疗前评估至关重要.
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