Renal osteodystrophy in a sample of patients on dialysis in Northeastern Brazil: a cross-sectional analysis.

IF 1.3 Q3 UROLOGY & NEPHROLOGY

Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia Pub Date : 2025-04-01 DOI:10.1590/2175-8239-JBN-2024-0174en

Luiz Alberto Soares de Araújo Coutinho, Ana Paula Santana Gueiros, Júlia Braga Vaz, Eduarda Cerqueira Russo, Vanda Jorgetti, José Edevanilson de Barros Gueiros

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Abstract

Introduction: Mineral and bone meta-bolism disorders in chronic kidney disease (CKD-MBD) are one of the most significant complications of CKD. The objective of this study was to describe the types of renal osteodystrophy (ROD) and the clinical and osteometabolic profiles of dialysis patients undergoing bone biopsy in Pernambuco.

Methods: A cross-sectional, retrospective study that assessed patients biopsied between January 2004 and September 2021 was conducted. Patients receiving conservative treatment for CKD, kidney transplant recipients, and those with inadequate biopsies were excluded. All clinical and laboratory parameters were from the time of biopsy.

Results: We assessed 250 patients with median age of 48 years (57.6% women) and on dialysis for a median time of 108 months. Regarding the diagnosis of ROD, the prevalence was: osteitis fibrosa (54.5%), mixed disease (30.4%), adynamic bone disease (12.4%), and osteomalacia (3.2%). The prevalences of osteoporosis, aluminum toxicity, and iron toxicity were 43.6%, 46.8% and 27.5%, respectively.

Conclusions: We demonstrated a high prevalence of diseases related to high bone turnover and aluminum toxicity.

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巴西东北部透析患者肾性骨营养不良：横断面分析。

慢性肾脏疾病（CKD- mbd）中矿物质和骨代谢紊乱是CKD最重要的并发症之一。本研究的目的是描述肾性骨营养不良（ROD）的类型以及伯南布哥州接受骨活检的透析患者的临床和骨代谢谱。方法：对2004年1月至2021年9月期间活检的患者进行横断面回顾性研究。接受CKD保守治疗的患者、肾移植接受者和活检不充分的患者被排除在外。所有临床和实验室参数均为活检时的数据。结果：我们评估了250例患者，中位年龄为48岁（57.6%为女性），透析中位时间为108个月。在ROD的诊断方面，患病率为：纤维性骨炎（54.5%）、混合性疾病（30.4%）、动力性骨病（12.4%）和骨软化（3.2%）。骨质疏松、铝毒性和铁毒性患病率分别为43.6%、46.8%和27.5%。结论：我们证明了高骨转换和铝毒性相关疾病的高患病率。

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