血液透析患者におけるiPTHと各種骨代謝マーカーとの相関性の意義

概要

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In hemodialysis (HD) patients, diagnosis and prognosis of bone quality based on bone metabolic marker levels are sometimes difficult, as the accuracy of marker assays is impaired by the lack of kidney function. Intact PTH (iPTH) has been reported to be associated with bone morphometry in renal osteodystrophy. We examined iPTH and bone metabolic markers to confirm whether they can be used to evaluate bone quality in HD patients. One thousand and two patients were involved in this study, and they were categorized into 10 groups according to the background of their disease. In the HD group, iPTH levels were very high, and ICTP, NTX, and OC had distributions similar to iPTH. We then examined the correlations between iPTH and bone metabolic markers in the HD group. Only OC was correlated with iPTH. Each marker was then divided into two groups based on iPTH level: "low" (iPTH <65pg/ml) and "high" (iPTH≧65pg/ml). All markers were correlated with iPTH in the "high" group, yet none were found to be correlated in the "low" group. Our results indicate that bone markers can be used as suitable indicators of bone turnover in HD patients when iPTH level is higher than 65pg/ml.
東京女子医科大学の論文