vestimИзвестия Национальной академии наук Беларуси. Серия медицинских наукProceedings of the National Academy of Sciences of Belarus, Medical series1814-60232524-2350The Republican Unitary Enterprise Publishing House "Belaruskaya Navuka"10.29235/1814-6023-2022-19-2-208-218vestim-845Research ArticleКЛИНИЧЕСКАЯ И ЭКСПЕРИМЕНТАЛЬНАЯ МЕДИЦИНАCLINICAL AND EXPERIMENTAL MEDICINEОценка минеральной плотности костной ткани у пациентов с вторичным гиперпаратиреозом на фоне хронической болезни почекAssessment of the bone mineral density in patients with secondary hyperparathyroisis due to chronic kidney diseaseКарловичН. В.KarlovichN. V.

Карлович Наталия Викторовна ‒ кандидат медицинских наук, доцент

пр-т Независимости, 64, 220040, г. Минск

Natalia V. Karlovich ‒ Ph. D. (Med.), Associate Professor

83, Dzerzhinski Ave., 220116, Minsk

natkarlovich@gmail.comМохортТ. В.MokhortT. V.

Мохорт Татьяна Вячеславовна ‒ доктор медицинских наук, профессор, главный научный сотрудник, заведующий кафедрой

пр-т Независимости, 64, 220040, г. Минск

Tatiana V. Mokhort ‒ D. Sc. (Med.), Professor, Chief Researcher, Head of the Department

83, Dzerzhinski Ave., 220116, Minsk

tatsianamokhort@gmail.comСпиридоноваО. С.SpiridonovaO. S.

Спиридонова Ольга Сергеевна ‒ младший научный сотрудник

пр-т Независимости, 64, 220040, г. Минск

Olga S. Spiridonova ‒ Junior Researcher

83, Dzerzhinski Ave., 220116, Minsk

spiry87@mail.ruСазоноваЕ. Г.SazonovaE. G.

Сазонова Елена Геннадьевна ‒ кандидат медицинских наук, врачэндокринолог

ул. Макаенка, 17, 220017, г. Минск

Elena G. Sazonova ‒ Ph. D. (Med.), Endocrinologist

17, Makayonok Str., 220017, Minsk

trofi_elena@mail.ruВасильеваН. А.VasilyevaN. A.

Васильева Наталья Анатольевна ‒ врач-рентгенолог

ул. Макаенка, 17, 220017, г. Минск

Natalya A. Vasilyeva ‒ Radiologist

17, Makayonok Str., 220017, Minsk

Белорусский государственный медицинский университетBelarusian State Medical UniversityРеспубликанский центр медицинской реабилитации и бальнеолеченияRepublican Center of Medical Rehabilitation and Balneotherapy202208062022192208218Copyright © Карлович Н.В., Мохорт Т.В., Спиридонова О.С., Сазонова Е.Г., Васильева Н.А., 20222022Карлович Н.В., Мохорт Т.В., Спиридонова О.С., Сазонова Е.Г., Васильева Н.А.Karlovich N.V., Mokhort T.V., Spiridonova O.S., Sazonova E.G., Vasilyeva N.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestimed.belnauka.by/jour/article/view/845

Диагностика остеопатии у пациентов с вторичным гиперпаратиреозом (ВГПТ) и хронической болезнью почек (ХБП) как одного из наиболее значимых последствий данной патологии является актуальной проблемой современной медицины. Проанализированы показатели минеральной плотности кости (МПК) по данным двойной рентгеновской абсорбциометрии, включая использование нейросетевого алгоритма, у 452 пациентов с различными стадиями ХБП и у 50 лиц группы сравнения (контроль). Установлена высокая распространенность остеопороза у пациентов с ХБП (от 13,8 до 28,2 % в разных регионах скелета), нарастающая до максимальных значений у пациентов со стадиями ХБП 4, 5 и у трансплантированных пациентов. Показано, что уровень паратгормона является важным, но не единственным фактором риска снижения МПК у пациентов с ХБП. Обосновано выполнение остеоденситометрии всем пациентам с ВГПТ на фоне ХБП, а также всем пациентам с терминальной стадией ХБП, в том числе перенесшим трансплантацию почки, вне зависимости от уровня ВГПТ. Оценку показателей остеоденситометрии необходимо выполнять во всех регионах скелета, максимальную значимость имеют T-критерии поясничного отдела позвоночника и проксимальных отделов бедренных костей.

Osteopathy in patients with SHPT and CKD is one of the most significant consequences of this pathology, the diagnostic issues of which are an urgent problem of medicine. The bone mineral density parameters were analyzed according to the double X-ray absorptiometry data for 452 patients with different stages of CKD and for 50 persons of the comparison group, including the use of a neural network algorithm. A high prevalence of osteoporosis in patients with CKD was established, from 13.8 to 28.2 % in different regions of the skeleton, increasing with the aggravation of the stage of CKD to maximum values in patients with CKD 4, 5 and in transplanted patients. It was shown that PTH is an important, but not the only risk factor for a bone mineral density reduction in patients with CKD. It was justified to perform osteodensitometry in all patients with SHPT against the background of CKD; all patients with end-stage CKD, as well as those who underwent kidney transplantation, regardless of the level of SHPT. Osteodensitometry indicators should be assessed in all regions of the skeleton, Tsc of the lumbar spine and the total hip have a maximum importance.

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The authors declare that there are no conflicts of interest present.