Nghiên cứu nồng độ Hormon tuyến cận giáp ở bệnh nhân ghép thận tại Bệnh viện Nhân Dân 115

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Tác giả: Minh Khuê Đàm, Đồng Dũng Ngô, Hữu Nhật Nguyễn, Văn Mỹ Phạm

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y Dược học Phạm Ngọc Thạch, 2023

Mô tả vật lý: tr.153

Bộ sưu tập: Metadata

ID: 339400

Thêm vào giỏ Liên kết toàn văn

- Đặt vấn đề: Cường chức năng tuyến cận giáp là một biến chứng quan trọng ở bệnh nhân bệnh thận mạn và tồn tại sau ghép thận gây bệnh xương sau ghép thận, có ảnh hưởng đến chức năng thận ghép và là nguy cơ bệnh tim mạch sau ghép thận.- Mục tiêu: Khảo sát nồng độ hormon tuyến cận giáp huyết thanh (Parathyroid Hormone - PTH) và tìm hiểu mối liên quan giữa nồng độ hormon tuyến cận giáp huyết thanh với một số yếu tố ở bệnh nhân ghép thận.- Đối tượng - phương pháp: Nghiên cứu cắt ngang 234 bệnh nhân ghép thận, theo dõi định kỳ tại bệnh viện Nhân Dân 115. Thu thập số liệu về nồng độ hormon tuyến cận giáp huyết thanh và một số đặc điểm của bệnh nhân sau ghép thận từ tháng 08/2020 đến 08/2021.- Kết quả: Trong tổng số 234 bệnh nhân ghép thận nghiên cứu có chủ yếu là bệnh nhân nam 172 (73,5%), tuổi trung bình: 49,5 ± 11,6 tuổi, eGFR trung bình: 70,0 ± 16,2 ml/phút. Bệnh nhân bệnh thận mạn giai đoạn 1T là 24 (10,3%), giai đoạn 2T là 157 (67,1%), giai đoạn 3T là 50 (21,3%), giai đoạn 4T là 3(1,3%) và không có bệnh nhân nào giai đoạn 5T. Thời gian lọc máu trước ghép thận trung bình là 28,2 ± 26,4 tháng (03 - 150), thời gian ghép thận trung bình: 54,6 ± 42,8 (3 - 216). 17,9% BN có nồng độ PTH huyết thanh bình thường, 82,1 % bệnh nhân tăng hormon tuyến cận giáp và không bệnh nhân nào có nồng độ hormon tuyến cận giáp thấp hơn bình thường. Trong nhóm BN tăng PTH có 63% tăng PTH mức độ nhẹ, 27,6% tăng PTH mức độ trung bình, 9,4% tăng PTH mức độ nặng. Nồng độ hormon tuyến cận giáp chưa thấy liên quan có ý nghĩa thống kê với thời gian lọc máu trước ghép thận, thời gian ghép thận và độ lọc cầu thận. - Kết luận: 82,1% bệnh nhân còn tăng hormon tuyến cận giáp huyết thanh sau ghép thận. Không có mối liên quan giữa nồng độ hormon tuyến cận giáp huyết thanh với thời gian lọc máu trước ghép thận, thời gian ghép thận và độ lọc cầu thận.Abstract- Background: Secondary hyperparathyroid hormone is a complication of chronic kidney disease and still exists after transplantation, leads to mineral bone disease, affects to kidney graft function and is associated with cardiovascular risk after kidney transplantation.- Objectives: To investigate the plasma parathyroid hormone (PTH) concentration and its relation to some factors of kidneytransplant recipients.- Subjects and Methods: Cross - sectional study in 234 patients aftertransplantation. Plasma parathyroid hormone concentration and some characteristics of patients after kidney transplant were collectedat 115 People Hospital from 08/2020 to 08/2021.- Results: A total of 234 patients, male patients were 172 (73.5%), mean age were 49.51 ± 11.68 years old, and mean eGFR is 70.0 ± 16.2 ml/min. Patients with CKD stage 1T were 24 (10.3%), stage 2T were 157 (67.1%), stage 3T were 50 (21.4%), stage 4T were 3(3.1%) and no patients were stage 5T. The mean duration of dialysis prior to transplantation was 28.2 ± 26.4 months (03 - 150). The mean time since trasplantation was 54.6 ± 42.8 (3 - 216) months. The mean parathyroid hormone level was 129.7 ± 84.5 pg/ml with 82.1% of patients having hyperparathyroidisim, 17.9% having normal parathyroid hormone level and no patient with hypo-concentrationof plasma parathyroid hormone. When the patients were classifified according to iPTH concentrations following the Kidney Disease Outcome Quality Initiative (K/DOQI) clinical practice guidelines: slight elevation was 63%, average elevation was 27.6% and severe elevation was 9.4%. We found no correllation between hyperparathyroidism and age, sex, duration since transplant, time on dialysis and eGFR.- Conclusion: 82.1% of patients still have elevation of plasma parathyroid hormone concentration after kidney transplantation. No correllation between hyperparathyroidism and age, sex, duration since transplant, time on dialysis and eGFR. DOI: 10.59715/pntjmp.1.4.17

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