Patients with analgetic nephropathy on chronic hemodialysis have a high incidence of severe secondary hyperparathyroidism.
Between 1996 and 1997, 86 patients were treated for terminal renal failure by hemodialysis at Maribor Teaching Hospital. Among them were 12 with iPTH over 900 pg/ml and symptoms of bone disease. In these patients bone biopsy was carried out with the aim of determining the type of renal osteodystrophy (RO) and establishing a possible correlation with the clinical picture, with densitometry and laboratory results. Histomorphologically, 6 patients fulfilled the criteria for secondary hyperparathyroidism (HT) - 3 with analgetic nephropathy (AN), one with chronic pyelonephritis (CPN), one with vascular nephropathy (VN), one with chronic glomerulonephritis (CGN). Six patients fulfilled the criteria for mixed osteodystrophy (MO) - 3 AN, 2 CGN, one VN. According to laboratory findings and bone mineral density (BMD), a statistically significant difference between HT and MO was present only in AP (Table 1). The most frequent diagnosis in patients with iPTH >900 pg/ml was analgetic nephropathy.
Pecovnik Balon
B
B
Department of Hemodialysis, Maribor Teaching Hospital, Maribor, Slovenia.
Krpan
D
D
D000700:Analgesics / Q000009:adverse effects*; D001706:Biopsy; D015519:Bone Density; D001842:Bone and Bones / Q000473:pathology; D002117:Calcitriol / Q000097:blood; D002118:Calcium / Q000097:blood; D012080:Chronic Kidney Disease-Mineral and Bone Disorder / Q000175:diagnosis; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000175:diagnosis / Q000209:etiology*; D007676:Kidney Failure, Chronic / Q000139:chemically induced* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D006435:Renal Dialysis / Q000009:adverse effects*
D000700:Analgesics; D010281:Parathyroid Hormone; D002117:Calcitriol; D002118:Calcium