Abstract:
AIM:Determine whether bone mineral density (BMD) assessed by dual-energy x-ray absorptiometry can be used as predictor of increased risk of death in hemodialysis patients. MATERIALS AND METHODS:A prospective study was performed of 516 patients with chronic kidney disease treated with hemodialysis (men 265, women 251, mean age 44.811.4 years) who were observed for 5.73.2 years. Before inclusion in the study, in all patients was analyzed bone mineral density using dual-energy X-ray absorptiometry in three standard departments: lumbar vertebrae, proximal femur and distal forearm. The probability analysis of the outcome was carried out using the KaplanMeier method and Cox. RESULTS:During follow-up period 111 (21.5%) patients died, 50.5% from cardiovascular events. Survival analysis by KaplanMeier method allowed to prove the increased risk of death from cardiovascular pathology in hemodailysis patients with low bone mineral density of all evaluated areas. Step-by-step multivariate Cox regression analysis showed that the T score of the femur, showing the difference of BMD of the patient with normal value of BMD for young adult, had the greatest prognostic significance. CONCLUSION:Reduced bone mineral density in patients receiving hemodialysis is associated with an increased risk of death from cardiovascular disease. Dual energy x-ray absorptiometry can be used for assessment of this risk. :Цель. Определить, может ли минеральная плотность костей (МПК), оцененная с помощью двухэнергетической рентгеновской абсорбциометрии, использоваться в качестве индикатора повышенного риска смерти у пациентов на гемодиализе. Материалы и методы. Выполнено проспективное исследование 516 пациентов с хронической болезнью почек, получающих лечение гемодиализом (мужчины 265, женщины 251; средний возраст 44,811,4 года), которых наблюдали в течение 5,73,2 года. Перед включением в исследование у всех пациентов анализировалась МПК с помощью двухэнергетической рентгеновской абсорбциометрии в трех стандартных отделах: поясничных позвонках, проксимальном отделе бедра и дистальном отделе предплечья. Вероятностный анализ результата проводился с использованием методов КапланаМейера и Кокса. Результаты. За период наблюдения умерли 111 (21,5%) больных, 50,5% от сердечно-сосудистых событий. Анализ выживаемости методом КапланаМейера позволил доказать повышенный риск смерти от сердечно-сосудистой патологии у получающих лечение гемодиализом больных с низкой МПК всех обследованных участков. Пошаговый многофакторный регрессионный анализ Кокса показал, что наибольшую прогностическую значимость имеет индекс Т бедренной кости, показывающий отличие МПК исследуемого пациента от нормальных значений МПК молодого взрослого человека. Заключение. Снижение МПК у больных, получающих лечение гемодиализом, ассоциируется с повышенным риском смерти от сердечно-сосудистой патологии, и двухэнергетическая рентгеновская абсорбциометрия может быть использована для оценки этого риска.
journal_name
Ter Arkhjournal_title
Terapevticheskii arkhivauthors
Mazurenko SO,Nakatis YA,Enkin AA,Staroselsky KG,Vasiliev AN,Mazurenko OG,Soin PV,Ermolaeva LG,Ivanov IGdoi
10.26442/00403660.2020.06.000277subject
Has Abstractpub_date
2020-07-09 00:00:00pages
33-36issue
6eissn
0040-3660issn
2309-5342journal_volume
92pub_type
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abstract:AIM:To review diagnostic approaches in chronic diseases of the small intestine. MATERIAL AND METHODS:A total of 1096 patients with chronic diseases of the small intestine were admitted to the clinic of the Central Research Institute of Gastroenterological Diseases in 1987-2006. RESULTS:Most of the patients (90.5%) ha...
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abstract::The hypotensive and diuretic properties of heparin were evaluated in 95 patients with different clinical and morphological varieties of chronic glomerulonephritis (CGN). The arterial blood pressure dropped in all the patients treated with heparin. The maximal effect was attained toward the end of heparin treatment (by...
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doi:
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更新日期:1984-01-01 00:00:00
abstract::The reparation activity in lymphocytes using the DNA reparative synthesis test was assessed in 18 patients: 10 suffering from primary gout with renal involvement, 6 suffering from chronic nephritis with hyperuricemia, 1 with hyperuricosuria and 1 with systemic lupus erythematosus. Inhibition of the DNA reparative synt...
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更新日期:1986-01-01 00:00:00
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journal_title:Terapevticheskii arkhiv
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
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abstract::Early diagnosis and adequate treatment are main components in prophylaxis of osteoporosis and ruptures. We examined 8578 postmenopausal and elderly women for osteoporosis. A total of 26084 examinations were made: x-ray absorptiometry, bone ultrasonometry, DEXA of low spine bones and proximal bone for mineral density l...
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更新日期:1986-01-01 00:00:00
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