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Vojnosanitetski pregled
2020, vol. 77, br. 5, str. 508-515
jezik rada: engleski
vrsta rada: izvorni naučni članak
objavljeno: 15/06/2020
doi: 10.2298/VSP171219107H
Creative Commons License 4.0
Uticaj sekundarnog hiperparatireodizma na lečenje anemije kod bolesnika na hroničnom programu hemodijalize
aMedical Center Tutin, Center of Hemodialysis, Tutin
bKlinički centar Kragujevac, Služba za laboratorijsku dijagnostiku + Univerzitet u Kragujevcu, Medicinski fakultet
cUniverzitet u Kragujevcu, Medicinski fakultet
dUniverzitet u Kragujevcu, Medicinski fakultet + Klinički centar Kragujevac, Centar za nuklearnu medicinu
eDžavni univerzitet u Novom Pazaru
fUniverzitet u Kragujevcu, Medicinski fakultet + Klinički centar Kragujevac, Klinika za urologiju, nefrologiju i dijalizu

e-adresa: nedimham@hotmail.com

Projekat

Analiza strukture troškova i uticaja na zdravstveni budžet Republike Srbije epidemiološki najmasovnijih i/ili najskupljih oboljenja i procena odnosa troškovi / efektivnost / korisnost medicinskih intervencija (MPNTR - 175014)

Sažetak

Uvod/Cilj. Anemija je česta komplikacija kod bolesnika na hemodijalizi. Na lečenje anemije utiču: nedostatak gvožđa, nedovoljna doza eritropoetina, mikroinflamacija, nedostatak vitamina D, povećana koncentracija intaktnog paratireoidnog hormona i neadekvatna hemodijaliza. Cilj rada bio je da se utvrdi prevalenca nedostatka vitamina D, kao i njegov uticaj na koncentraciju hemoglobina u krvi, status gvožđa, mikroinflamaciju, malnutriciju, adekvatnost hemodijalize i dozu eritropoetina kod bolesnika na redovnoj hemodijalizi. Metoda. Ispitivanjem je bilo obuhvaćeno 120 bolesnika podeljenih u tri grupe: grupa sa teškim deficitom vitamina D - koncentracija 25-hidroksi vitamina D [25(OH)D] < 10 ng/mL; grupa sa deficitom vitamina D - koncentracija 25(OH)D 10-20 ng/mL; grupa sa nedovoljnim nivoom vitamina D - koncentracija 25(OH)D > 20 ng/mL. Za statističku analizu korišćeni su: Kolmogorov Smirnov test, jednofaktorska parametarska analiza varijanse-ANOVA i Kruskal-Wallis-ov test. Rezultati. Prevalenca snižene koncentracije 25(OH)D u serumu bolesnika koji su se lečili redovnom hemodijalizom iznosila je 75,83%, a prevalenca teškog nedostatka vitamina D 24,17%. Bolesnici sa teškim deficitom vitamina D u serumu imali su statistički značajno nižu koncentraciju hemoglobina u krvi, hematokrita, koncentraciju ukupnih proteina i albumina u serumu i vrednosti parametara adekvatnosti hemodijalize. Koncentracija C-reaktivnog proteina u serumu bila je statistički značajno viša kod bolesnika sa teškim deficitom vitamina D u serumu, u odnosu na bolesnike sa koncentracijom 25(OH)D u serumu ≥ 10 ng/mL. Zaključak. Bolesnici sa teškim deficitom vitamina D u serumu imaju manju koncentraciju hemoglobina u krvi, manje adekvatnu hemodijalizu, značajnu mikroinflamaciju, malnutriciju, poremećaj metabolizma koštanog tkiva i zahtevaju veću dozu eritropoetina u odnosu na bolesnike sa koncentracijom 25(OH)D ≥ 10 ng/mL. Vitamin D je značajan faktor rizika od razvoja i lečenja anemije kod bolesnika na redovnom programu hemodijalize.

Ključne reči

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