التفاصيل البيبلوغرافية
| العنوان: |
HIPOPARATIREOIDIZAM U BOLESNIKA NA HEMODIJALIZI. (Croatian) |
| Alternate Title: |
HYPOPARATHYROIDISM IN HEMODIALYSIS PATIENTS. (English) |
| المؤلفون: |
PAVLOVIĆ, DRAŠKO, HORVATIĆ, IVICA, DOKO, SLAVA, HRŠAK, IVANČICA, DITS, SONJA, STRINAVIĆ, DIJANA KNEŽEVIĆ, KUDUMIJA, BORIS |
| المصدر: |
Acta Medica Croatica; 2022, Vol. 76 Issue 2/3, p159-163, 5p |
| مصطلحات موضوعية: |
VITAMIN D receptors, OLDER patients, VITAMIN D, HEMODIALYSIS patients, ALKALINE phosphatase |
| Abstract (English): |
Although secondary hyperparathyroidism (SHPT) is a common complication in hemodialysis patients, in some patients the concentration of parathyroid hormone (PTH) is relatively low, which can be defined as relative hypoparathyroidism (RhPT). The aim of this study was to examine the association of the occurrence of RhPT with clinical and laboratory characteristics of patients and their medication. Patients and methods: We conducted an observational cross-sectional study in hemodialysis patients at three centers. Altogether 199 patients were included. There were 127 men and 72 women, mean age 66 years and mean duration of hemodialysis 5.7 years. The following parameters were determined: age, sex, diabetes (DM), duration of hemodialysis, drugs, and laboratory parameters (Ca, P, PTH, albumin, alkaline phosphatase). RhPT was defined as PTH concentration <21.6 pmol/L. Results: RhPT was statistically significantly associated with older age (mean age 70.5 vs. 65.1 years, p=0.026), DM (p=0.042), not taking phosphate binders in therapy (p=0.001), not taking vitamin D receptor activator (aVDR) (p<0.001) and taking vitamin D (p<0.001). In multivariate logistic regression, the following independent predictors for RhPT were found: DM (OR 2.585; 95% CI=1.247-5.359), vitamin D therapy (OR 3.704, 95% CI=1.579-8.687), and negative independent predictors for RhPT were taking phosphate binders (OR 0.221; 95% CI=0.059-0.829) and taking aVDR (OR 0.248; 95% CI=0.107-0.575). Conclusion: Diabetes mellitus and vitamin D therapy are associated with a higher risk of RhPT, and therapy with phosphate binders and aVDRs with a lower risk of RhPT. The possible cause is that patients with significant SHPT are treated with aVDR. In elderly patients and those with DM, caution is recommended because RhPT is associated with slow bone remodeling. [ABSTRACT FROM AUTHOR] |
| Abstract (Croatian): |
Sekundarni hiperparatireoidizam (SHPT) česta je komplikacija u bolesnika na hemodijalizi, međutim u nekih bolesnika mogu biti prisutne relativno niske koncentracije parathormona (PTH), tj. relativni hipoparatireoidizam (RhPT). Cilj rada je ispitati povezanost pojave RhPT s kliničkim i laboratorijskim obilježjima bolesnika te s lijekovima koje uzimaju. Bolesnici i metode: Proveli smo opservacijsko presječno istraživanje u bolesnika na hemodijalizi u tri centra. Uključeno je 199 bolesnika (127 muškaraca, 72 žene) prosječne dobi 66 godina i srednjeg trajanja hemodijalize 5,7 godina. Bolesnicima su određeni sljedeći parametri: dob, spol, šećerna bolest (DM), trajanje hemodijalize, vrsta lijekova koje uzimaju te laboratorijski parametri: Ca, P, PTH, albumin, alkalna fosfataza. RhPT je definiran kao koncentracija PTH < 21,6 pmol/L. Rezultati: RhPT je bio statistički značajno povezan sa starijom dobi (prosječne dobi 70,5 prema 65,1 godina, p=0,026), šećernom bolesti (DM) (p=0,042), neuzimanjem vezača fosfata u terapiji (p=0,001), neuzimanjem aktivatora receptora vitamina D (aVDR) (p<0,001) i s uzimanjem vitamina D (p<0,001). U multivarijatnoj logističkoj regresiji, kao nezavisni prediktori za RhPT nađeni su: DM (OR 2,585; 95 % CI=1,247-5,359) terapija vitaminom D (OR 3,704, 95 % CI=1,579-8,687), a negativni nezavisni prediktori uzimanje vezača fosfata (OR 0,221; 95 % CI=0,059-0,829) i uzimanje aVDR (OR 0,248; 95 % CI=0,107-0,575). Zaključak: Šećerna bolest i terapija vitaminom D povezani su s većim rizikom RhPT, a terapija vezačima fosfata i aVDR s manjim rizikom RhPT. U starijih bolesnika i onih s DM treba biti oprezan, jer je RhPT povezan s usporenom pregradnjom kosti. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
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