在线血液过对CKD-5d儿童骨周转的影响:前性队列研究
Mohammed F Kasem1, Ragia M Said2, Aliaa Mourad1
1Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Pediatric nephrology (Berlin, Germany)
|May 19, 2025
概括
在线血液过 (OL-HDF) 改善了慢性病 (CKD-5d) 的儿童的骨周转. 这种治疗显著降低了FGF-23和TRAP-5b水平,同时增加了BALP,这表明儿童CKD患者对骨健康的潜在益处.
科学领域:
- 儿科脏病学 儿科脏病学
- 矿物和骨疾病 矿物和骨疾病
- 脏替代疗法治疗 脏替代疗法
背景情况:
- 矿物骨疾病 (MBD) 是患有慢性病 (CKD) 的儿童常见的并发症.
- 在线血液过 (OL-HDF) 是血液透析和血液过的组合,正在探索其在治疗儿科慢性病患者的并发症方面的潜在益处.
研究的目的:
- 评估OL-HDF对末期病 (CKD-5d) 儿童骨周转标记物的影响.
- 评估纤维细胞生长因子23 (FGF-23),可溶性Klotho,骨性酸酶 (BALP) 和耐酸酸酶5b (TRAP-5b) 水平的变化.
主要方法:
- 一组31名患有CKD-5d的儿童,在血液透析 (HD) 上稳定至少3个月,被转换为经稀释后的OL-HDF12个月.
- 基线和12个月的随访评估包括血清中的Ca,PO4,白蛋白,性酸酶,iPTH,CRP,可溶性Klotho,FGF-23,BALP和TRAP-5b的水平.
主要成果:
- OL-HDF导致FGF-23和FGF-23/Klotho比率显著降低,Klotho水平没有显著增加.
- 观察到BALP和BALP/TRAP-5b比率的显著增加,TRAP-5b的显著下降.
- 在12个月的随访期间,没有发现对身高Z-score有显著影响.
结论:
- 在患有CKD-5d的儿童中,OL-HDF对骨循环标志物产生了显著的积极影响.
- 观察到的FGF-23,Klotho,BALP和TRAP-5b的变化表明,OL-HDF可能是管理MBD的有益治疗方式.
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