Dialysis encephalopathy and osteomalacic bone disease
Identifieur interne : 005131 ( Main/Exploration ); précédent : 005130; suivant : 005132Dialysis encephalopathy and osteomalacic bone disease
Auteurs : Jerilynn C. Prior [Canada] ; E. C. Cameron [Canada] ; W. J. Knickerbocker [Canada] ; Vincent P. Sweeney [Canada] ; O. Suchowersky [Canada]Source :
- The American Journal of Medicine [ 0002-9343 ] ; 1982.
Abstract
Nine patients on long-term hemodialysis with dialysis encephalopathy were studied, with sex matched control subjects for eight of the patients. Each patient with dialysis encephalopathy and control subject were contemporaries in a similar dialysis environment. Rib and other fractures were found in excess in the patients with dialysis encephalopathy (p < 0.005 and p < 0.01). These patients had less radiographic hyperparathyroid bone disease, and no more osteopenia as measured by metacarpal thickness than did their control counterparts. Severe osteomalacia was documented by bone biopsy in four of the patients. In a retrospective review of clinical, biochemical and pharmacologic differences, the patients with dialysis encephalopathy were significantly older at the start of dialysis (45.6 years versus 38.6 years, p < 0.02) and had higher mean concentrations of blood urea nitrogen (BUN) and lower serum hemoglobin in the first year of dialysis than the control subjects. Blood pressure, weight, creatinine, calcium, phosphate, alkaline phosphatase and a number of transfusions did not differ significantly. There was no difference in prescribed vitamin D and elemental aluminum in phosphate binders. This study demonstrates that patients with dialysis encephalopathy had more rib fractures without more parathyroid or osteopenic bone disease than did the control subjects and suggests that the etiology of dialysis encephalopathy and osteomalacia is multifactorial.
Url:
DOI: 10.1016/0002-9343(82)90574-5
Affiliations:
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Prior</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Vancouver, British Columbia</wicri:regionArea><wicri:noRegion>British Columbia</wicri:noRegion></affiliation></author><author><name sortKey="Cameron, E C" sort="Cameron, E C" uniqKey="Cameron E" first="E. C." last="Cameron">E. C. Cameron</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Vancouver, British Columbia</wicri:regionArea><wicri:noRegion>British Columbia</wicri:noRegion></affiliation></author><author><name sortKey="Knickerbocker, W J" sort="Knickerbocker, W J" uniqKey="Knickerbocker W" first="W. J." last="Knickerbocker">W. J. 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Suchowersky</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Vancouver, British Columbia</wicri:regionArea><wicri:noRegion>British Columbia</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j">The American Journal of Medicine</title><title level="j" type="abbrev">AJM</title><idno type="ISSN">0002-9343</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1982">1982</date><biblScope unit="volume">72</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="33">33</biblScope><biblScope unit="page" to="42">42</biblScope></imprint><idno type="ISSN">0002-9343</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0002-9343</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Nine patients on long-term hemodialysis with dialysis encephalopathy were studied, with sex matched control subjects for eight of the patients. Each patient with dialysis encephalopathy and control subject were contemporaries in a similar dialysis environment. Rib and other fractures were found in excess in the patients with dialysis encephalopathy (p < 0.005 and p < 0.01). These patients had less radiographic hyperparathyroid bone disease, and no more osteopenia as measured by metacarpal thickness than did their control counterparts. Severe osteomalacia was documented by bone biopsy in four of the patients. In a retrospective review of clinical, biochemical and pharmacologic differences, the patients with dialysis encephalopathy were significantly older at the start of dialysis (45.6 years versus 38.6 years, p < 0.02) and had higher mean concentrations of blood urea nitrogen (BUN) and lower serum hemoglobin in the first year of dialysis than the control subjects. Blood pressure, weight, creatinine, calcium, phosphate, alkaline phosphatase and a number of transfusions did not differ significantly. There was no difference in prescribed vitamin D and elemental aluminum in phosphate binders. This study demonstrates that patients with dialysis encephalopathy had more rib fractures without more parathyroid or osteopenic bone disease than did the control subjects and suggests that the etiology of dialysis encephalopathy and osteomalacia is multifactorial.</div></front></TEI><affiliations><list><country><li>Canada</li></country></list><tree><country name="Canada"><noRegion><name sortKey="Prior, Jerilynn C" sort="Prior, Jerilynn C" uniqKey="Prior J" first="Jerilynn C." last="Prior">Jerilynn C. Prior</name></noRegion><name sortKey="Cameron, E C" sort="Cameron, E C" uniqKey="Cameron E" first="E. C." last="Cameron">E. C. Cameron</name><name sortKey="Knickerbocker, W J" sort="Knickerbocker, W J" uniqKey="Knickerbocker W" first="W. J." last="Knickerbocker">W. J. Knickerbocker</name><name sortKey="Suchowersky, O" sort="Suchowersky, O" uniqKey="Suchowersky O" first="O." last="Suchowersky">O. Suchowersky</name><name sortKey="Sweeney, Vincent P" sort="Sweeney, Vincent P" uniqKey="Sweeney V" first="Vincent P." last="Sweeney">Vincent P. Sweeney</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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