Renal Osteodystroph in Hemodialysis Patients
Resource
中華民國腎臟醫學會雜誌 v.3 n.1 pp.41-51
Journal
中華民國腎臟醫學會雜誌,v.3
Journal Issue
n.1
Pages
41-51
Date Issued
1989
Date
1989
Author(s)
LEE, SU-HUI
HSIEH, SUN-TE
HUANG, TIEN-SHANG
CHANG, TON-RONG
Abstract
We studied osteodystrophy in 60 hemodialysis patients. Serum PTH was measured by mm-PTH RIA Kit. There was a significant correlation between parathyroid hormone (mm-PTH) and calcium times phosphorus product (Ca×P). For those with very high mm-PTH or symptoms, we advised them to do bone biopsy. Bone specimens were obtained from the anterior superior iliac crest. Intrerpretation of bone histology followed the criteria suggested by Ritz and Llach. Aluminum (Al) was stained with aurine tricarboxylic acid. Eighteen patients agreed to have bone biopsy. There were 7 pure osteitis fibrosa (OF), 7 pure osteomalacia (OM), 2 mixed form (MX), 1 aplastic bone disease and 1 without apparent bone disease. Their biochemical data were analyzed. OM patients had significant lower serum P , Alk P-tase and mm- PTH and higher Ca level than OF patients. All OM andmixed form patients had abnormal liver function test. The number of mixed and aplastic forms were too small to analyze. There were 5 positive aluminum stain in OM and none in OF. The aluminum stain of the aplastic bone specimen was strongly positive. Conclusion: 1. OM patients had lower mm-PTH blood level and might have poor parathyroid response to various stimuli or under some inhibition, 2. Aluminum played a significant role in the pathogenesis of OM and aplastic bone disease, 3. All OM and mixed form have abnormal liver function, 4. OM had low bone turnover rate and OF had high bone turnover rate.#C2189003
Subjects
腎性骨病變
鋁染色
中段副甲狀腺荷爾蒙
骨病
RENAL OSTEODYSTROPHY
ALUMINUM STAIN
MM-PTH
BONE DISEASE