1 / 24

Grupo de Estudio del Metabolismo Fosfocálcico Sociedad Uruguaya de Nefrología

Grupo de Estudio del Metabolismo Fosfocálcico Sociedad Uruguaya de Nefrología. Cátedra de Nefrología – Facultad de Medicina Montevideo – Uruguay. METABOLISMO FOSFOCALCICO (AÑO 1985). CALCIO n = 339 9 ± 1.3 mg/dl < 8 mg/dl 14 %

orinda
Download Presentation

Grupo de Estudio del Metabolismo Fosfocálcico Sociedad Uruguaya de Nefrología

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Grupo de Estudio del Metabolismo FosfocálcicoSociedad Uruguaya de Nefrología Cátedra de Nefrología – Facultad de Medicina Montevideo – Uruguay

  2. METABOLISMO FOSFOCALCICO(AÑO 1985) • CALCIO n = 339 9 ± 1.3 mg/dl < 8 mg/dl 14 % 8 – 9 mg/dl 33 % 9.1 – 11 mg/dl 51% > 11 mg/dl 2%

  3. METABOLISMO FOSFOCALCICO(AÑO 1985) • FOSFORO n = 339 5.5 ± 1.4 mg/dl < 5.5 mg/dl 48% 5.5 – 7 mg/dl 40% > 7 mg/dl 12 %

  4. METABOLISMO FOSFOCALCICO(AÑO 1985) • PTH n = 339 8 – 1.2 9 % 1.3 – 5 46 % 5.1 – 10 25 % > 1020 %

  5. METABOLISMO FOSFOCALCICO(abril – octubre 2004) n = 2415 M: 59.6 % F: 40.4 % EDAD: 59.8 ± 16.9 años (2 – 94) Ca: 9.03 ± 0.79 mg/dl (5 – 11.5) P: 5.8 ± 1.6 mg/dl (1.3 – 11) FA: 272 ± 222 (15 – 2000) PTHi: 484 ± 533 pg/ml (2.3 – 4000)

  6. METABOLISMO FOSFOCALCIOPAUTAS DOQI • CALCIO: 8.4 - 9.5 mg/dl • FOSFORO: 3.5 - 5.5 mg/dl • PTHi: 150 – 300 pg/ml

  7. METABOLISMO FOSFOCALCICO(abril - octubre 2004) n = 2415 • Calcio < 8.4 mg/dl 20.7 % 8.4 – 9.5 mg/dl52.6 % > 9.5 mg/dl 26.8 % • Fósforo < 3.5 mg/dl 5.5 % 3.5 – 5.5 mg/dl39.8 % > 5.5 mg/dl 54.7 % • PTHi > 150 pg/ml 29 % 150 – 300 pg/ml21.6 % > 300 pg/ml 49.4 %

  8. METABOLISMO FOSFOCALCICO(abril - octubre 2004)

  9. Cannata et al* SUN (n = 7512) (n = 2415) PTHi < 150 47 % 29 % 150 – 300 22 % 21.6 % > 300 31 % 49.4 % P > 5.5 49 % 54.7 % * Sólo 9.5% tenían Ca, P, PTHi y PxCa dentro del rango propuesto por las pautas K/DOQI (Cannata et al, JASN 14: 474A, 2003).

  10. Epidemiology of Renal Osteodystrophy in UruguayCurrent indications of bone biopsies H. Caorsi*, I. Olaizola*, L. Labruna#, V. Jorgetti&, G. Acuña*, A. Petraglia*, L. Fajardo*, A. Alvarez*, P Ambrosoni*. * Grupo de estudio del metabolismo Fosfocálcico – Sociedad Uruguaya de Nefrología – Uruguay # Histomorfometría Osea. Instituto de Reumatología, Montevideo - Uruguay & Histomorfometría Osea. Universidad de Sao Paulo, Sao Paulo - Brasil

  11. Aims • To analyze the prevalence of the different types of bone disease over the time in dialysis patients in Uruguay. • To determine current indication of bone biopsy in the diagnosis of renal osteodystrophy. Bone Biopsies and Clinical Features of Patients1985 – 2000 • 167 Bone biopsies from hemodialysis symptomatic patients. • 4% Diabetics. • 93 Female; 74 Male. • Age: 54 ± 13 years. • Length of dialysis: 53 ± 33 months

  12. ResultsFrequency of Different Histological Forms1985 – 2000 n = 167

  13. ResultsHistological Diagnosis According to Year of Bone Biopsies1985 – 2000 1985 - 1990 HD pts./year: 1187 n = 66 BB 1991 - 1996 HD pts./year: 1602 n = 84 BB 1997 - 2000 HD pts./year: 2254 n = 17 BB c b % Al in MF: 42.5 ± 47a % Al in MF : 20 ± 28a % Al in MF : 27 ± 18 ap < 0.001; bp < 0.01; cp < 0.05 % samples [Al]water: 88% (< 10 μg/l) 97% (< 2 μg/l)

  14. ResultsFreqcuency of Adinamic Bone Disease with and without Aluminium Over the Time

  15. Renal Osteodystrophyin UruguayBone Biopsy RegistryiPTH levels iPTH pg/ml 1400 1300 1200 1100 1000 900 800 700 600 500 400 300 200 100 0 p < 0,001 OF OMa y ABDa

  16. Conclusions • Survival rates of patients on dialysis have increased with improve crescent of dialytic therapy, but the resultant increased duration of dialysis has led to rise in hyperparathyroidism. Our results show a significant increase in osteitis fibrosa in the last years. This can be explained by a longer time on dialysis of the patients. • On the other hand, low turnover bone disease aluminium related (OM and ABD) decreased significantly, and we find that ABD without aluminium appears in the last period. • The percentage of aluminium in the mineralization front in bone biopsies has diminished over the time. • The modification of histological forms observed should be related to the improvement in the dialysis water treatment and the reduction of oral aluminium exposure.

More Related