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2007, Cilt 5, Sayı 1, Sayfa(lar) 007-012
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The Bone Cycle in Periton Dialysis and Kidney Transplantation Patients
Nilgün Arıkan Başaran1, Aykut Saral2, Nihal Yücel3, Gülçin Kantarcı4, Asuman Orçun3
1Göztepe Eğitim ve Araştırma Hastanesi, Tıbbi Biyokimya Kliniği, İstanbul
2Devlet Hastanesi, Tıbbi Biyokimya Kliniği, Eskişehir
3Kartal Eğitim ve Araştırma Hastanesi, Tıbbi Biyokimya Kliniği, İstanbul
4Göztepe Eğitim ve Araştırma Hastanesi, Nefroloji Kliniği, İstanbul
Keywords: Renal osteodystrophia, periton dialysis, kidney transplantation, 25 (OH) vitamin D3, parathormone, osteocalcine

Objective: It has been known that bone health is ruined in patients with chronical kidney disorders. Renal osteodystrophia is a frequent complication of dialysis patients. In this sectional study we aimed to investigate the bone metabolism of patients who had undergone kidney transplantation and who receive regular periton dialysis (PD) treatment.

Materials and Methods: 28 patients with PD continuity, 30 patients with kidney transplantations and 30 healthy people were enrolled in this study. Bone density and biochemical parameter, namely 25 (OH) D3 vitamini (OH-D3), parathormone (PTH), osteocalcine (Ost), calcium (Ca), phosphorus and alkalene phosphatase (ALP) were measured and compared between groups.

Results: The levels in PD patients were significantly different compared to control group (mean±SD); 10.20±7.08 nmol/L (p<0.001) for OH-D3, 538.87±692.47 pg/mL (p=0.002) for PTH, 44.81±33.47 ng/ml (p<0.001) for Ost, 0.81±0.13 g/cm2 (p<0.001) for Bone Mineral Density at the left femoral neck (BMDfemur) and 133.32±119.45 U/L (p=0.007) for ALP. However, Bone Mineral Density at the Lumbar (L2-L4) spine (BMD spine) levels of PD patients were not different from control group (p=0.82). The levels of transplantation group were 22.70±14.82 nmol/L for OH-D3, 73.64±61.15 pg/mL for PTH, 8.14±10.61 ng/mL for Ost, 0.96±0.19 g/cm2 for BMD spine, 0.85±0.15 g/cm2 for BMD femur and 64.43±28.63 U/L for ALP. Among those parameters only PTH (p=0.008) and BMD femur (p=0.001) were different from control group.

Conclusion: The ruined bone metabolism in patients with kidney insufficiency was partially recovered by replacing the kidney function in renal transplantation patients.


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