211Cases Maintenance Hemodialysis Patients: Calcaneus Bone Mineral Density And Related Indicators Analysis

Objective:This topic measure the bone mineral density of211patients withmaintenance hemodialysis, at the same time measure the patient’s generalcondition and related indicators, and discusses the relationship between them，aiming at improving the knowing, diagnosis, and treatment of the maintenancehemodialysis patients and also provide new clues for pathogenesis research andprecaution.Method:The patients in this analysis is211,who were accepted maintenancehemodialysis in the second hospital of jilin university from September2011toOctober2011,measure their calcaneus bone mineral density with bone mineraldensity instrument,and the same time, record general data and related biochemicalindicators.We use an application of SPSS statistical software to get thestatistical results.Results:1. Primary disease situation of regular hemodialysis patients is as follows：first the primary disease is chronic glomerulonephritis (n=73), followed bydiabetes nephropathy (n=70), the third is hypertensive nephrosclerosis(n=30). In this three groups of the primary diseases, the proportion of patients over60years old are chronic glomerulonephritis (21.9%)、diabetic nephropathy (58.6%),hypertensive nephrosclerosis(43.3%). The majority of older than sixty yearspatients are diabetic nephropathy（58.6%）. The proportion of elderly patients withdiabetic nephropathy and hypertensive nephrosclerosis is obviously higher thanthe group of chronic glomerulonephritis(p＜0.05).2.The relationship with age,gender:compare the ages of normal bone massand osteopenia group,no statistical difference (p>0.05). In the Osteoporosisgroup,the proportion of patients older than sixty years is highest, and comparewith twenty-forty years old and forty-sixty years old groups, all have statisticaldifference (p <0.05), twenty-forty years old and forty-sixty years old, nostatistically significant differences between comparison (p>0.05). The proportionof women older than sixty years old of osteoporosis is obviously higher than thatof the male, has significant statistical difference (p <0.01). Compare betweennormal bone mass and osteopenia group,no statistical difference (p>0.05).3.The relationship with height, weight, body mass index：height, weight,body mass index of osteoporosis patients are lower than those of normal bonemass and osteopenia group, have statistically significant difference (p <0.05).height, weight, body mass index of osteopenia group are less than bone massnormal group, but no statistical difference (p>0.05).4.The relationship with primary disease:the rate of osteoporosis in chronic glomerulonephritis is46.6%(34/73cases), diabetes nephropathy is38.6%(27/70cases), hypertensive nephrosclerosis is43.3%(13/30cases)the rate of chronicinterstitial nephritis is66.7%（16/24cases）,the rate of others (including polycystickidney disease, chronic pyelonephritis, obstructive nephropathy) is57.1%(8/14cases), Chronic interstitial nephritis has the highest incidence of osteoporosis(66.7%), diabetic has the lowest (38.6%).chronic interstitial nephritis and diabeticnephropathy group, has difference compared with statistical significance (p <0.05).5.The relationship with dialysis time:along with the extension of dialysis, theproportion of osteoporosis gradually raised, and dialysis time>5years comparedwith other time has statistical difference (p <0.05).6.The relationship with biochemical indicators:osteoporosis patients serumphosphorus （1.89±0.65）and parathyroid hormone level （376.93±78.43）areobviously higher than that of normal bone mass（1.66±0.47，194.79±63.27）and bone mass reduction group（1.66±0.55，316.10±69.57）, and each groupwith statistical difference (p <0.05). normal bone mass alkaline phosphatase（71.60±29.14）is lower than bone mass reduction group（82.06±32.74） andosteoporosis group（90.37±33.23）,and compared with bone mass reductiongroup has no statistical difference (p>0.05), and osteoporosis group comparedwith has statistical difference (p <0.05). serum calcium, hemoglobin content hasno statistical difference (p>0.05). Conclusion:1.The first primary disease of maintenance hemodialysis patients is chronicglomerulonephritis, the second is diabetic nephropathy, and the third ishypertensive nephrosclerosis.2.In the elderly patients,the proportion of chronic glomerulonephritis reduces,diabetic nephropathy and hypertensive nephrosclerosis increases, the majority ofpatients older than sixty years is diabetic nephropathy(58.6%).3.Old age (age> sixty years old) and female are risk factors withosteoporosis; Urine toxicity dialysis patients with short stature, low weight, lowbody mass index are also risk factors;with dialysis time extension, the incidenceof osteoporosis increaces.4.Chronic interstitial nephritis patients have the highest rates of osteoporosis66.7%（16/24cases）.5.Dialysis in patients with osteoporosis,serum phosphorus, parathyroidhormone has negatively correlated; High alkaline phosphatase is a risk factor ofosteoporosis; and serum calcium, hemoglobin are unrelated.