Učestalost prijeloma kostiju u bolesnika na hemodijalizi: hrvatski rezultati

Disturbances of bone mineral metabolism are common complications of chronic kidney disease with bone fractures as one of the most important consequences. The aim of this study was to estimate prevalence of bone fractures among Croatian hemodialysis patients and to determine the possible fracture risk. The study was carried out in 767 hemodialysis patients from nine Croatian hemodialysis centers. Demographic, laboratory and bone fracture data were collected from medical records as well as therapy with vitamin D analogs. Fragility fractures were defined according to the World Health Organization definition. In 31 patient a total of 36 fractures were recorded. The prevalence of patients with bone fractures was 4.0%. The mean age of patients with fractures was 68.6 years. There were 9 male and 22 female patients with frac- tures. The mean hemodialysis duration was 63.3 months. Among all fractures the most common were hip fractures (39%) followed by forearm fractures (22%). This is the first study regarding epidemiology of bone fractures in Croatian hemodialysis patients. The prevalence of patients with bone fractures in our group of hemodialysis patients is high. Fractures were more frequent among women and older patients, patients who have been longer on dialysis and in patients with higher concentration of PTH.Poremećaj mineralnog metabolizma kostiju česta je komplikacija kroničnog bubrežnog zatajenja s povećanim rizikom prijeloma kostiju. Cilj ovog istraživanja je određivanje učestalosti bolesnika s prijelomima kostiju među hrvatskim bolesnicima na hemodijalizi te ispitivanje čimbenika rizika za nastanak prijeloma. Istraživanje je provedno među 797 bolesnika na hemodijalizi u 9 hrvatskih centara za dijalizu. Pregledom medicinske dokumentacije zabilježeni su kliničkom obradom dokazani prijelomi kostiju, demografski podatci, laboratorijski podatci te podatci o terapiji analozima vitamina D. U tridesetjednog bolesnika zabilježeno je tridesetšest prijeloma. Učestalost bolesnika s prijelomima kostiju je 4,0%. Srednja dob bolesnika s prijelomima je 68,6 godina. Prijelomi su zabilježeni u devet muškaraca i dvadesetdvije žene. Srednje trajanje dijalize je 63,3 mjeseca. Najčešće zabilježeni prijelomi su prijelomi kuka (39%) i podlaktice (22%). 16 bolesnika s prijelomima je bilo na terapiji kalcitriolom ili parikalcitriolom u vrijeme nastanka prijeloma. Ovo je prvo istraživanje o prijelomima kod hrvatskih bolesnika na hemodijalizi. Učestalost bolesnika s prijelomima je visoka, prijelomi su učestaliji kod starijih bolesnika, žena, bolesnika koji su duže na dijalizi i bolesnika povišenim vrijednostima PTH