/ % 0% 酶酶 ESRD 酶 The purpose of this study was to describe and explore the relationship between hemodialysis related information and fracture e

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徘织艾
9 years ago
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2 / % 0% 酶酶 ESRD 酶 The purpose of this study was to describe and explore the relationship between hemodialysis related information and fracture experience among hemodialysis patients. A cross-sectional design was used. One hundred and eight subjects were recruited from a dialysis centers by purposive sampling. Their charts were surveyed by the structured questionnaire. Fifty-two percent of subjects were female with a mean age of 64.08±13.40 years. The mean age of ESRD diagnosed was years. The range of dialysis duration was 1-4 years, the mean was 7.86 years. Forty-nine percent of subjects had one time experience of A-V shunt dysfunction at least, and they were happened during the first half year around 8%. Eighty-eight percent of subjects had one or more kinds of chronic disease excluding ESRD. Twenty percent of subjects had fracture experience behind dialysis. The age, duration of dialysis, and ALP of subjects with fracture experience were higher significantly than those without fracture experience. ALP and ipth had significant positive correlation with duration of dialysis. The age of fracture happening had significant negative correlation with ALP. There were no bone mineral density (BMD) reports among subjects. It was worth thinking why subjects didn t be arranged to examine their bone density. These findings were useful for designing a bone health intervention protocol for ESRD patients. I

3 ,143 (end-stage renal disease, ESRD) 1,41 94% 6% [1] [] renal osteodystrophy, ROD [3] [4] ESRD [4,5] [6,7] bone remodeling ESRD [3] [3] [3,7] 1 parathyroid hormone, PTH osteocalcin, bone-alp, PICP, CTX [14] ALP, PTH, DPD BMD[6] [7,8] [9] Stehman-Breen BMD [10] 1

4 ESRD (hemodialysis, HD) (continuous ambulatory peritoneal dialysis, CAPD) BMD BMD [7] Taal 48.9 heparin [4] Lindberg Moe [3]Stehman-Breen BMI PTH [10]Alem [11] Gupta ESRD ESRD.6 [1] ESRD ESRD Tierney [13] [14] combination therapy [14]

5 (cross-sectional & survey design) (Purposive Sampling) SPSS for Window ( )t (Pearson s correlation) ± ESRD ± ESRD % 5 CAPD 3

6 13 1% % % 14 13% 55/ % 7 5% 6.5% % % 95 88% 30% 73% 38 35% % % % % 9 酶 ALP Hb 3 酶 ALP Hb 4

7 Stehman-Breen 000Gabay 1993Alem 000 酶 ALP Hb ESRD ipth 酶 ALP 4 酶 ESRD 酶酶 ESRD 酶酶 108 Bone-ALPiPTH ;14: Chu TS: Pathophysiology of uremia. Formasan J Med 000;4: Lindberg JS, Moe SM: Osteoporosis in end-stage renal disease. Seminars in Nephrology 1999;19():

8 4. Taal MW, Masud T, Green D, Cassidy MJ: Risk factors for reduced bone density in haemodialysis patients. Nephrol Dial Transplant 1999;14: Erlichman M, Holohan TV: Bone densitometry: patients with end-stage renal disease. Health Technology Assessment 1996 Mar;8: Ha SK, Park CH, SEO JK et al: Studies on bone markers and bone mineral density in patients with chronic renal failure. Yonsei Med J 1996;37(5):350-6.(Abstract) 7. Gabay G, Ruedin P, Slosman D et al: Bone mineral density in patients with end-stage renal failure. Am J Nephrol 1993;13: Rix M, Andreassen H, Eskildsen P, Langdahl B, Olgaard K: Bone mineral density and biochemical markers of bone turnover in patients with predialysis chronic renal failure. Kidney Int 1999;56: ( ) 1997; Stehman-Breen CO, Sherrard DJ, Alem AM, Gillen DL et al: Risk factors for hip fracture among patients with end-stage renal disease. Kidney Int 000;58: Alem AM, Sherrard DJ, Gillen DL et al. Increased risk of hip fracture among patients with end-stage renal disease. Kidney Int 000;58: Gupta A, Kallenback LR, Divine GW: Increased risk of hip fractures in US Medicare end-stage renal disease (ERSD) patients. J Am Soc Nephrol 1997;8:55 (abstr) 13. Tierney GS, Goulet JA, Greenfield ML, Port FK.Mortality after fracture of the hip in patients who have end-stage renal disease. J Bone and Joint Surgery (American Volume) 1994;76(5): Neyhart CD: A Multidisciplinary renal osteoporosis clinic: A new role for the nephrology nurse. Nephrology Nursing Journal 000;7(3):

9 1 n= < ESRD < kg, n= cm, n= BMIn=88 < ~

10 n=108 n= n=

11 t p * * 酶 ALP * Hb * ipth ALP ipth -0.84* ** 0.448** 0.30** -0.58*n= **n=45 * p0.05 ** p0.01two-tailed 9

一位末期腎病

一位末期腎病 . 弘光學報 50 期. 一位末期腎病患者於加護病房面臨血液透析衝擊之護理經驗傅淑禎 1 林麗君 1 劉波兒 2 * 1 光田醫院大甲分院 2 弘光科技大學護理系收到日期 :95.10.13 修訂日期 :96.1.9 接受日期 :96.2.6 摘要本文是探討一位末

/ % 0% 酶 酶 ESRD 酶 The purpose of this study was to describe and explore the relationship between hemodialysis related information and fracture e

/ % 0% 酶酶 ESRD 酶 The purpose of this study was to describe and explore the relationship between hemodialysis related information and fracture e