말기 신질환 환자에서의 신장 이식술후 골대사 지표의 변화 = Change in Bone Metabolism Index After Transplantation in Patients with End Stage Renal Disease말기 신질환 환자에서의 신장 이식술후 골대사 지표의 변화

다국어 초록 (Multilingual Abstract)

Renal osteodystrophy includes a11 skeletal abnormalities in end stage renal disease, i.e., osteitis fibrosa, osteomalacia, osteosclerosis and growth failure in children. Patients who undergo kidney transplantation may continu to have evidence of disease of the skeletal system, frequently associated with abnormalities in the homeostasis of calcium and phosphorus. The authors measured the bone metabolism indox with the purpose of determining the usefulness of renal transplantation in patients with renal osteodystrophy. This was accomplished by observing the changes in the serum levels of calcium, phosphorus, alkaline phosphatase, PTH, and osteocalcin, and in the bone scintigraphy and degree of bone loss by scanning densitometry before and 1 month after renal transplantation in 9 patients with end renal disease and renal osteo dystrophy. The results were as follows: 1) The serum calcium level was significantly increased to the normal range one month after kidney transplantation (7.28±0.96 mg/dl vs 9.12±0.14 mg/dl, p＜0.01), 2) One month after kidney transplantation, the serum level of phosphorus, PTH and osteocalcin were significantly decreased compared with pretransplantation values (phosphorus : 3.17±0.74 mg/dl vs 7.92±1.66mg/dl, p<0.01; PTH: 0.47±0.11 ng/ml vs 4.67±3.79ng/ml p<0.05; osteocalcin : 3.47±0.87ng/ml vs 24.41±9.04 ng/ml p<0.01) 3) There was a significant decrease in the bone scan score after renal transplantation compared with the pretransplantation value (- 0.2±0.4 vs 1.1±0.3, p<0.05). 4) There were no differences in serum alkaline phosphatase (ALP) activity and the index of bone density before and after renal transplantation (ALP: 56,67±23.02IU/L vs 40.33±17.27IU/L, p>0.1; bone density △Gmax 3.43±0.19 vs 3.46±0.85 △Gmin 2.83±0.41 vs 2.76±0.73, and MCI 0.62±0.08 vs 0.67±0.03, all p>0,1). In conclusion, renal osteodystrophy with end stage renal disease is corrected by successful renal transplantation.