PREDICTORS OF FRACTURES IN PATIENTS WITH STAGE VD CHRONIC KIDNEY DISEASE TREATED WITH HEMODIALYSIS

Authors

  • Mykola Ankin Shupyk National Medical Academy of Postgraduate Education, Kyiv. Ukraine, Ukraine
  • Taras Petryk Municipal non-profit enterprise of Kyiv Regional Council «Kyiv Regional Clinical Hospital». Ukraine, Ukraine
  • Sergii Dudar Shupyk National Medical Academy of Postgraduate Education, Kyiv. Ukraine, Ukraine
  • Viktoriia Ladyka Shupyk National Medical Academy of Postgraduate Education, Kyiv. Ukraine, Ukraine

DOI:

https://doi.org/10.15674/0030-59872023118-24

Keywords:

Predictors of fractures, kidneys, hemodialysis, laboratory parameters

Abstract

Bone pathology begins in the early stages of chronic kidney disease (CKD), but clinical consequences — bone pain and fractures — occur mainly at stage 5 of the disease (VD) in patients who use methods renal replacement therapy. Objective. To find out the frequency, localization and possible predictors of fractures in patients with CKD VD stage on the background of hemodialysis according to the results of a prospective study. Methods. 254 patients
were included in the cohort prospective open study with CKD VD stage, which was treated with hemodialysis hemodialysis during 2018‒2022. The study was conducted in two stages. On the first, based on the analysis of medical documentation, received data on the presence of fractures of all localizations, diabetes, hypertension, secondary hyperparathyroidism, hyperhydration, type of initial vascular access, eKt/V, body mass index (IMT), peripheral vascular disease. At the second stage, a prospective study of new cases of fractures was conducted. Results. Examined72 (32.3 %) women and 151 (67.7 %) men, average age — (49.4 ± 14.03) years — did not differ significantly depending on gender (p = 0.1088). The most frequent cause of CKD stage VD was glomerulonephritis — 111 patients (49.77 %). At the time of the beginning of observation, 30 cases were ascertained fractures in 26 patients, and at the end — 62 in 51 patients. By the results of univariate Cox regression analysis it was established that independent predictors of occurrence new fractures are the patientʼs age, female gender, smoking, presence of peripheral vascular diseases, BMI, as well as serum albumin, parathyroid hormone, calcium, phosphorus, alkaline phosphatase, and vitamin D levels. Conclusions. The developed method of fracture risk assessment for patients with CKD VD stage on the background of hemodialysis is individualized, accessible in execution and interpretation, allows to distinguish patients with increased risk the occurrence of fractures with the help of standard bases clinical and laboratory indicators.

Author Biographies

Mykola Ankin, Shupyk National Medical Academy of Postgraduate Education, Kyiv. Ukraine

MD, Prof. in Traumatology and Orthopаedics

Taras Petryk, Municipal non-profit enterprise of Kyiv Regional Council «Kyiv Regional Clinical Hospital». Ukraine

PhD in Traumatology and Orthopаedics

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How to Cite

Ankin, M., Petryk, T. ., Dudar, S. ., & Ladyka, V. (2023). PREDICTORS OF FRACTURES IN PATIENTS WITH STAGE VD CHRONIC KIDNEY DISEASE TREATED WITH HEMODIALYSIS. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (1), 18–24. https://doi.org/10.15674/0030-59872023118-24

Issue

No. 1 (2023)

Section

ORIGINAL ARTICLES

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