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  • Author: Milorad Grujicic x
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Andreja Figurek, Vlastimir Vlatkovic, Dragan Vojvodic, Branislav Gasic and Milorad Grujicic

Abstract

Introduction. Renal osteodystrophy is a severe complication of chronic kidney disease (CKD) that increases morbidity and mortality in these patients. Mineral and bone disorder starts early in CKD and affects the incidence of bone fractures. The aim of this study was to observe the frequency of diverse bone fractures in patients with CKD not on dialysis.

Methods. This cohort study included 68 patients that were followed during the two-year period. The patients were divided into two cohorts: one that developed bone fractures and the other that did not. There were 35 (51.5%) men and 33 (48.5%) women. The mean age of patients ranged 62.88±11.60 years. During follow-up serum values of chronic kidney disease – mineral and bone indicators were measured. The methods of descriptive and analytical statistics were used in order to analyze obtained data.

Results. During this two-year follow-up seven patients developed bone fractures. Among them, females dominated (6 patients) compared to males (only 1 patient). The most common were fractures of forearm. The mean level of parathyroid hormone (PTH) at the beginning of the monitoring was higher in the group of patients with bone fractures (165.25 ± 47.69 pg/mL) in regard to another group (103.96 ± 81.55 pg/mL). After two-year follow-up, this difference became statistically significant at the level p < 0.05. Patients that developed bone fractures had higher FRAX (Fracture Risk Assessment) score compared to another group.

Conclusion. In our study, about 10% of patients had bone fractures in the two-year follow-up period. Patients who developed fractures had a higher PTH level and FRAX score.

Open access

Andreja Figurek, Vlastimir Vlatkovic, Dragan Vojvodic and Milorad Grujicic

Abstract

Goodpasture syndrome is a severe illness caused by the formation of antibodies to the glomerular basement membrane and alveolus with consequential damage to renal and pulmonary function. With current therapy, long-term survival is more than 50%. Before, the mortality was higher than 90%.

In our patient, the disease began as dysuria, continued as anaemic syndrome, and ended with the development of end-stage renal failure.

Immunosuppressive therapy with pulse doses of methylprednisolone and cyclophosphamide has put the disease into remission, but the permanent impairment of renal function remained.

Early diagnosis of Goodpasture syndrome helps preserve renal function and improves patients’ survival. In patients who achieve remission, a kidney transplant can be considered. Currently, our patient is awaiting transplantation