Öz
Kronik böbrek yetmezliği (KBY) tanısı ile diyaliz programında izlenen hastalarda vasküler ve diğer yumuşak doku kalsifikasyonları, sekonder hiperparatiroidizm ve kalsiyum-fosfor metabolizması bozukluklarına ikincil gelişir. Bu hastalarda damar duvarında meydana gelen kalsifikasyonlar, mortalite ve morbiditenin başlıca nedeni olan kardiyovasküler hastalıkların gelişimine önemli derecede katkıda bulunur.Bu yazıda, uzun süreli hemodiyaliz programında izlediğimiz ve gastrik mukozasında kalsifikasyon odakları saptadığımız bir hasta sunulmakta, KBY'li çocuk hastalarda gelişen yumuşak doku kalsifikasyonlarının tanı ve tedavisi gözden geçirilmektedir.
Anahtar Kelimeler
Sekonder hiperparatiroidizm yumuşak doku kalsifikasyonu çocukluk dönemi böbrek yetmezliği diyaliz
Kaynakça
- Aladrén Regidor MJ: Cinacalcet reduces vascular and soft tissue calcification in secondary hyperparathyroidism (SHPT) in hemodialysis patients. Clin Nephrol 2009; 71: 207-213
- Balcı M, Kırkpantur A, Gulbay M, Gurbuz OA: Plasma fibroblast growth factor-23 levels are independently associated with carotid artery atherosclerosis in maintenance hemodialysis patients. Hemodial Int 2010; 14: 425-432
- Briese S, Wiesner S, Will JC, Lembcke A, OpgenRhein B, Nissel R, Wernecke KD, Andreae J, Haffner D, Querfeld U: Arterial and cardiac disease in young adults with childhood-onset end-stage renal disease-impact of calcium and vitamin D therapy. Nephrol Dial Transplant 2006; 21: 1906-1914
- Civilibal M, Caliskan S, Adaletli I, Oflaz H, Sever L, Candan C, Canpolat N, Kasapcopur O, Kuruoglu S, Arisoy N: Coronary artery calcifications in children with end-stage renal disease. Pediatr Nephrol 2006; 21: 1426-333
- Hu MC, Kuro-o M, Moe OW: Klotho and kidney disease. J Nephrol 2010; 23 (Suppl 16) S:136-144
- Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Work Group: KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int 2009; ( suppl 113) S1-130
- Kuro-O M: Phosphate and Klotho. Kidney Int 2011; 121 (Suppl 21) S:20-23
- Lumpaopong A, Mathew AV, John E, Jelnin V, Benedetti E, Testa G, Oberholzer J, Sankary H, Ruiz C: Early coronary calcification in children and young adults with end-stage renal disease. Transplant Proc 2007; 39: 37-39
- Milliner DS, Zinsmeister AR, Lieberman E, Landing B: Soft tissue calcification in pediatric patients with end-stage renal disease. Kidney Int 1990; 38: 931936
- Oh J, Wunsch R, Turzer M, Bahner M, Raggi P, Querfeld U, Mehls O, Schaefer F: Advanced coronary and carotid arteriopathy in young adults with childhood-onset chronic renal failure. Circulation 2002; 106: 100-105
- Raggi P, Chertow GM, Torres PU, Csiky B, Naso A, Nossuli K, Moustafa M, Goodman WG, Lopez N, Downey G, Dehmel B, Floege J: ADVANCE Study Group.The ADVANCE study: a randomized study to evaluate the effects of cinacalcet plus low-dose vitamin D on vascular calcification in patients on hemodialysis. Nephrol Dial Transplant. 2011; 26: 1327-39
- Shroff RC, Donald AE, Hiorns MP, Watson A, Feather S, Milford D, Ellins EA, Storry C, Ridout D, Deanfield J, Rees L: Mineral metabolism and vascular damage in children on dialysis. J Am Soc Nephrol 2007; 18: 2996-3003
- Srivaths PR, Goldstein SL, Silverstein DM, Krishnamurthy R, Brewer ED: Elevated FGF 23 and phosphorus are associated with coronary calcification in hemodialysis patients. Pediatr Nephrol 2011; 26: 945-951
Öz
In chronic hemodialysis patients, vascular and soft tissue calcifications occur secondary to hyperparathyroidism and disturbances in calcium- phosphate metabolism. In these patients, vascular calcifications significantly contribute to cardiovascular events, which is the main cause of morbidity and mortality. In this report, we present a pediatric patient on hemodialysis who developed gastric mucosa calcifications and review diagnosis and treatment of soft tissue calcifications.
Anahtar Kelimeler
Secondary hyperparathyroidism soft tissue calcification childhood renal failure dialysis
Kaynakça
- Aladrén Regidor MJ: Cinacalcet reduces vascular and soft tissue calcification in secondary hyperparathyroidism (SHPT) in hemodialysis patients. Clin Nephrol 2009; 71: 207-213
- Balcı M, Kırkpantur A, Gulbay M, Gurbuz OA: Plasma fibroblast growth factor-23 levels are independently associated with carotid artery atherosclerosis in maintenance hemodialysis patients. Hemodial Int 2010; 14: 425-432
- Briese S, Wiesner S, Will JC, Lembcke A, OpgenRhein B, Nissel R, Wernecke KD, Andreae J, Haffner D, Querfeld U: Arterial and cardiac disease in young adults with childhood-onset end-stage renal disease-impact of calcium and vitamin D therapy. Nephrol Dial Transplant 2006; 21: 1906-1914
- Civilibal M, Caliskan S, Adaletli I, Oflaz H, Sever L, Candan C, Canpolat N, Kasapcopur O, Kuruoglu S, Arisoy N: Coronary artery calcifications in children with end-stage renal disease. Pediatr Nephrol 2006; 21: 1426-333
- Hu MC, Kuro-o M, Moe OW: Klotho and kidney disease. J Nephrol 2010; 23 (Suppl 16) S:136-144
- Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Work Group: KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int 2009; ( suppl 113) S1-130
- Kuro-O M: Phosphate and Klotho. Kidney Int 2011; 121 (Suppl 21) S:20-23
- Lumpaopong A, Mathew AV, John E, Jelnin V, Benedetti E, Testa G, Oberholzer J, Sankary H, Ruiz C: Early coronary calcification in children and young adults with end-stage renal disease. Transplant Proc 2007; 39: 37-39
- Milliner DS, Zinsmeister AR, Lieberman E, Landing B: Soft tissue calcification in pediatric patients with end-stage renal disease. Kidney Int 1990; 38: 931936
- Oh J, Wunsch R, Turzer M, Bahner M, Raggi P, Querfeld U, Mehls O, Schaefer F: Advanced coronary and carotid arteriopathy in young adults with childhood-onset chronic renal failure. Circulation 2002; 106: 100-105
- Raggi P, Chertow GM, Torres PU, Csiky B, Naso A, Nossuli K, Moustafa M, Goodman WG, Lopez N, Downey G, Dehmel B, Floege J: ADVANCE Study Group.The ADVANCE study: a randomized study to evaluate the effects of cinacalcet plus low-dose vitamin D on vascular calcification in patients on hemodialysis. Nephrol Dial Transplant. 2011; 26: 1327-39
- Shroff RC, Donald AE, Hiorns MP, Watson A, Feather S, Milford D, Ellins EA, Storry C, Ridout D, Deanfield J, Rees L: Mineral metabolism and vascular damage in children on dialysis. J Am Soc Nephrol 2007; 18: 2996-3003
- Srivaths PR, Goldstein SL, Silverstein DM, Krishnamurthy R, Brewer ED: Elevated FGF 23 and phosphorus are associated with coronary calcification in hemodialysis patients. Pediatr Nephrol 2011; 26: 945-951
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Olgu Sunumu |
| Yazarlar | |
| Yayımlanma Tarihi | 15 Nisan 2013 |
| Gönderilme Tarihi | 2 Temmuz 2012 |
| Yayımlandığı Sayı | Yıl 2012 Cilt: 75 Sayı: 4 |
Kaynak Göster
Contact information and address
Addressi: İ.Ü. İstanbul Tıp Fakültesi Dekanlığı, Turgut Özal Cad. 34093 Çapa, Fatih, İstanbul, TÜRKİYE
Email: itfdergisi@istanbul.edu.tr
Phone: +90 212 414 21 61