Overview of renal osteodystrophy in Brazil: a cross-sectional study.

Autor:	Carbonara CEM; Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Divisão de Nefrologia, Campinas, SP, Brazil.; Universidade Estadual de Campinas, Faculdade de Ciências Médicas da Campinas, Laboratório para o Estudo do Metabolismo Mineral e Ósseo em Nefrologia, Campinas, Campinas, SP, Brazil., Roza NAV; Universidade Estadual de Campinas, Faculdade de Ciências Médicas da Campinas, Laboratório para o Estudo do Metabolismo Mineral e Ósseo em Nefrologia, Campinas, Campinas, SP, Brazil., Reis LM; Universidade de São Paulo, Faculdade de Medicina, Departamento de Medicina Interna, Laboratório de Fisiopatologia Renal, São Paulo, SP, Brazil., Carvalho AB; Universidade Federal de São Paulo, São Paulo, SP, Brazil., Jorgetti V; Universidade de São Paulo, Faculdade de Medicina, Departamento de Medicina Interna, Laboratório de Fisiopatologia Renal, São Paulo, SP, Brazil., Oliveira RB; Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Divisão de Nefrologia, Campinas, SP, Brazil.; Universidade Estadual de Campinas, Faculdade de Ciências Médicas da Campinas, Laboratório para o Estudo do Metabolismo Mineral e Ósseo em Nefrologia, Campinas, Campinas, SP, Brazil.
Jazyk:	English; Portuguese
Zdroj:	Jornal brasileiro de nefrologia [J Bras Nefrol] 2023 Apr-Jun; Vol. 45 (2), pp. 257-261.
DOI:	10.1590/2175-8239-JBN-2022-0146en
Abstrakt:	Introduction: The epidemiologic profile of renal osteodystrophy (ROD) is changing over time and cross-sectional studies provide essential information to improve care and health policies. The Brazilian Registry of Bone Biopsy (REBRABO) is a prospective, nationalmulticenter cohort that includes patients with chronic kidney disease (CKD) undergoing bone biopsy. REBRABO aims to provide clinical information on ROD. The main objective of this subanalysis was to describe the profile of ROD, including clinically relevant associations. Methods: From Aug/2015 to Dec/2021, 511 patients with CKD who performed bone biopsy were included in the REBRABO platform. Patients with no bone biopsy report (N = 40), GFR > 90 mL/min (N = 28), without asigned consent (N = 24), bone fragments inadequate for diagnosis (N = 23), bone biopsy indicated by a specialty other than nephrology (N = 6), and < 18 years old (N = 4) were excluded. Clinical-demographic data (e.g., age, sex, ethnicity, CKD etiology, dialysis vintage, comorbidities, symptoms, and complications related to ROD), laboratory (e.g., serum levels of total calcium, phosphate, parathormone, alkaline phosphatase, 25-hydroxyvitamin D, and hemoglobin), and ROD (e.g., histological diagnosis) were analyzed. Results: Data from 386 individuals were considered in this subanalysis of REBRABO. Mean age was 52 (42-60) years; 198 (51%) were male; 315 (82%) were on hemodialysis. Osteitis fibrosa (OF) [163 (42%)], adynamic bone disease (ABD) [96 (25%)] and mixed uremic osteodystrophy (MUO) [83 (21%)] were the most frequent diagnosis of ROD in our sample; 203 (54%) had the diagnosis of osteoporosis, 82 (56%) vascular calcification; 138 (36%) bone aluminum accumulation, and 137 (36%) iron intoxication; patients with high turnover were prone to present a higher frequency of symptoms. Conclusions: A high proportion of patients were diagnosed with OF and ABD, as well as osteoporosis, vascular calcification and clinical symptoms.
Databáze:	MEDLINE
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