Korean Journal of Nephrology 1990;9(1):43-57.

만성신부전의 (慢性腎不全) 신성골이영양증에 (腎性骨異營養症) 대한 (對) 혈액투석 (血液透析) 복막투석 (腹膜透析) 및 신이식 (腎移植) 의 - Microdensitometer 法을 中心으로 -

신범철 , 구자룡 , 차대룡 , 조원용 , 김형규 , 정태시 ( 申範澈 , 具滋龍 , 車大龍 , 趙源容 , 金亨圭 , 鄭泰時 )

Abstract

Renal osteodystrophy (ROD) of chronic renal failure is a major problem of chronic renal failure patient who were treated with hemodialysis, CAPD and renal trans- plantation. By the way, authors inspected the bone changes of ROD which were measured by microden- sitometer method (MD) with Inoue in CRF on hemodialysis (5 patients), CAPD (11 patients) and renal transplantation (3 patiets). Also they were evaluated the metabolic index of bone change such as serum Ca, P, alkaline phosphatase, creatinine and iPTH which were speculated the correla- tion of MD index in each groups. The result obtained were as follows: 1) MCI of normal female was significantly higher than that of CRF, d of normal female under 30 years was lower than that of CRF (p<0.05). The correlation of iPTH and serum P, alkaline phosphatase and iPTH, d and Ca, and so on alkaline phosphatase and Gsmin were positive significantly (p<0.05). 2) In maintenance hemodialysis group of CRF, d and Gsmax was decreased and serum Ca increased after hemodialysis significantly (p<0.05). MCI and serum BUN, Gsmin and BUN, also alkaline phosphatase and d showed positive correlation (p<0.05). A MCI of mainte- nance hemodialysis group of CRF was lower than that of CRF, d of which was decreaed (p<0.05). The serum Ca and alkaline phosphatase of which was increased significantly (p<0.05). 3) In CAPD group of CRF, Gsmin and GS/D were lower than that of CRF and serum BUN, Ca, P were decreased (p<0.05). A Gsmin of CAPD group whose serum BUN, creatinine and P were decreased after CAPD. P & GS/D revealed a positive correlation (p<0. 05). Gsmax, Gsmin, GS/D and serum Ca, GS/D show a negative correlation (p<0.05). 4) In renal trnsplantation group of CRF, Gsmax of renal transplantation was higher and serum BUN, creatinine, Ca, alkaline phsphatase of those were higher than that of CRF, significantly (p<0.05). There were increased d and decreased serum BUN, creatinine and P after renal transplantation (p<0.05). This results suggest that CAPD for CRF is more effective to treat ROD than hemodialysis and renal transplantation. The bone index of MD method and metabdic index such as seum Ca, P, alkaline phopatase and iPTH are useful to detect or moniter a change of ROD clinicaly.