RENALNA OSTEODISTROFIJA KOD PACIJENATA NA HEMODIJALIZI.

Renal osteodistrophy is one of the most common complications of chronic renal failure and one of the risk factors of increased mortality among chronic haemodialysis patients. Aim of the study was to evaluate frequency of renal osteodistrophy in our dialysis population and to identify demographic, clinical and laboratory parameters associated with poor phosphorus and PTH control. Research included 100 patients on chronic haemodialysis program three times weekly for four hours with programmed ultrafiltration. Average age was 52,6 years and there were 55 males and 45 females in total, with average haemodialysis length of six years. Average calcium value was 2,19±0,190 mmol/L, 10% of patients had hypercalcaemia Ca>2,4 mmol/L. 58 patients (60,5%) involved in study had hyperphosphataemia and calcium-phosphorus product >4,4 mmol2/L2. Secondary hyperparathyroidism was found in 64 patients (64%), respectively to PTH>300 pg/ml. There was no significant correlation between patients' age, haemodialysis length, levels of PTH and phosphorus in tested dialysis population. Parathyreoidectomy was performed in 10 patients (16%), with significant lowering of PTH (959,7 pg/ml vs. 163,3 pg/ml). Conclusions: Our study has shown poorly controlled levels of phosphate in blood. In our dialysis population 60,5% of patients had P04 >1,8 mmol/L and 49% of the patients had calcium-phosphorus product >4,4 mmol2/L2, with the levels of PTH>300pg/ml. In 10% of our patients parathireidectomya was done because of SHP. Results show the need for intensive education of patients in restricting phosphorus intake as a preventive measure in reducing bone diseases in patients on haemodialysis. Multidisciplinary approach in treating secondary hyperparathyroidism includes doctor, nurse, dietitian, patient and his/her family, because renal osteodistrophy relates to increased morbidity and mortality of haemodialysis patients. [ABSTRACT FROM AUTHOR]