PDF(Pubmed)
Abstract：
Chronic kidney disease (CKD) is among the most significant health problems, with the associated cardiovascular disease and bone metabolism disorders being the leading cause of morbidity and mortality in these patients. The aim of the study was to determine markers of bone turnover in patient sera (phosphates, calcium, alkaline phosphatase, parathyroid hormone and osteoprotegerin (OPG)) in all stages of kidney failure including kidney transplant recipients. We also wanted to determine whether dialysis vintage affects recovery of bone markers one year after transplantation. There were 164 study patients, whereas 30 healthy individuals served as a control group. Serum OPG progressively increased with decline of the glomerular filtration rate. The highest OPG concentration was recorded in dialysis group. We observed a statistically significant OPG increase in stage 2 CKD. In kidney transplant group, there was positive correlation between OPG and dialysis vintage. We also found that serum OPG was lower in patients treated with dialysis for less than 4 years prior to transplantation. We confirmed that CKD-mineral and bone disorder began in stage 3 CKD with parathyroid hormone and OPG elevation, and a statistically significant OPG increase in stage 2 CKD might be an early sign of CKD-mineral and bone disorder. Dialysis vintage longer than 4 years is associated with more significant disturbances in mineral and bone metabolism.
摘要：
慢性肾脏病（CKD）是最重要的健康问题之一，与相关的心血管疾病和骨代谢紊乱是这些患者发病和死亡的主要原因。该研究的目的是确定患者血清中骨转换的标志物（磷酸盐，钙，碱性磷酸酶,甲状旁腺激素和骨保护素（OPG））在肾衰竭的所有阶段，包括肾移植受者。我们还想确定透析年份是否会影响移植后一年骨标志物的恢复。有164名研究患者，而30名健康个体作为对照组。随着肾小球滤过率的下降，血清OPG逐渐增加。透析组OPG浓度最高。我们观察到2期CKD中OPG的统计学显著增加。在肾移植组中，OPG与透析年份呈正相关。我们还发现，在移植前接受透析治疗少于4年的患者中，血清OPG较低。我们证实，CKD-矿物质和骨骼疾病始于3期CKD，伴有甲状旁腺激素和OPG升高，2期CKD中OPG的统计学显着增加可能是CKD矿物质和骨骼疾病的早期征兆。透析年份超过4年与矿物质和骨代谢更明显的紊乱有关。
