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doctoral thesis
Prevencija gubitka koštane mase pamidronatom nakon transplantacije bubrega
Zagreb: University of Zagreb, School of Medicine, 2013. urn:nbn:hr:105:577372
Kuliš, Tomislav
University of Zagreb
School of Medicine

Institutional repository: Dr Med - University of Zagreb School of Medicine Digital Repository

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Kuliš, T. (2013). Prevencija gubitka koštane mase pamidronatom nakon transplantacije bubrega (Doctoral thesis). Zagreb: University of Zagreb, School of Medicine. Retrieved from https://urn.nsk.hr/urn:nbn:hr:105:577372

Kuliš, Tomislav. "Prevencija gubitka koštane mase pamidronatom nakon transplantacije bubrega ." Doctoral thesis, University of Zagreb, School of Medicine, 2013. https://urn.nsk.hr/urn:nbn:hr:105:577372

Kuliš, Tomislav. "Prevencija gubitka koštane mase pamidronatom nakon transplantacije bubrega ." Doctoral thesis, University of Zagreb, School of Medicine, 2013. https://urn.nsk.hr/urn:nbn:hr:105:577372

Kuliš, T. (2013). 'Prevencija gubitka koštane mase pamidronatom nakon transplantacije bubrega ', Doctoral thesis, University of Zagreb, School of Medicine, accessed 28 April 2024, https://urn.nsk.hr/urn:nbn:hr:105:577372

Kuliš T. Prevencija gubitka koštane mase pamidronatom nakon transplantacije bubrega [Doctoral thesis]. Zagreb: University of Zagreb, School of Medicine; 2013 [cited 2024 April 28] Available at: https://urn.nsk.hr/urn:nbn:hr:105:577372

T. Kuliš, "Prevencija gubitka koštane mase pamidronatom nakon transplantacije bubrega ", Doctoral thesis, University of Zagreb, School of Medicine, Zagreb, 2013. Available at: https://urn.nsk.hr/urn:nbn:hr:105:577372

Metadata
TitlePrevencija gubitka koštane mase pamidronatom nakon transplantacije bubrega
Title (english)Efficacy of pamidronate in prevention of bone loss after renal transplantation
AuthorTomislav Kuliš
Mentor Željko Kaštelan (mentor)
Committee membernije dostupno (član povjerenstva)
GranterUniversity of Zagreb
School of Medicine
Zagreb
Defense date and country2013-04-26, Croatia
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Universal decimal classification
(UDC)		61 - Medical sciences
Abstract
Uvod: Gubitak koštane mase kod bolesnika nakon transplantacije bubrega predstavlja važan klinički problem budući da se na već postojeće oštećenje kosti (posljedica kronične bubrežne bolesti), koštana masa dodatno gubi radi imunosupresivne terapije. Gubitak koštane mase najviše je izražen u tijeku prve godini nakon transplantacije bubrega. Bisfosfonati su lijekovi koji smanjuju resorpciju kosti te su se pokazali učinkovitima u liječenju mnogih bolesti, poput osteoporoze i multiplog mijeloma. Dosadašnja istraživanja pokazala su dobar učinak bisfosfonata na prevenciju gubitka kosti nakon transplantacije bubrega. Trenutno, ne postoji ujednačen stav o primjeni navedene terapije, pa tako niti o optimalnoj dozi, trenutku započinjanja s terapijom te trajanju terapije. Cilj ovog istraživanja je ispitati učinkovitost niskih doza pamidronata u prevenciji gubitka koštane mase u prvoj godini nakon transplantacije bubrega. ----- Bolesnici i metode: U ispitivanju je sudjelovalo 36 bolesnika kojima je transplantiran bubreg u KBC Zagreb. U ispitivanoj skupini koja je primala pamidronat u dozi 0.5mg/kg u dva navrata, unutar mjesec dana od transplantacije bubrega te mjesec dana nakon prve doze lijeka, uključeno je 19 bolesnika. U kontrolnoj skupini uključeno je 17 bolesnika. Promjena koštane mase mjerena je DXA denzitometrijom u tri navrata, neposredno nakon transplantacije bubrega, potom 6 i 12 mjeseci nakon transplantacije. ----- Rezultati: Istraživanje je potvrdilo učinak pamidronata te je pokazalo smanjenje gubitka koštane mase u ispitivanoj skupini u odnosu na kontrolnu. Smanjenje gubitka koštane mase je statistički značajno na lumbalnoj kralježnici na šest mjeseci te granično izraženo na Wardovom trokutu bedrene kosti isto na šest mjeseci od transplantacije bubrega. U studiji nije zabilježen negativni učinak primijenjenog lijeka na funkciju presatka. ----- Zaključak: Pamidronat smanjuje gubitak koštane mase u ranom periodu nakon transplantacije bubrega. Moguće je preporučiti ovakvu shemu doziranja pamidronata u svrhu prevencije gubitka koštane mase, a uz minimalni rizik od neželjenih učinaka. Dodatna istraživanja su potrebna radi dobivanja odgovora na pitanje kod kojih skupina bolesnika bi primjena lijeka bila medicinski i ekonomski opravdana.
Abstract (english)
Introduction: Bone loss in kidney transplant recipients presents an important problem since it adds on already present uremic osteodistrophy. Additional bone loss is mostly caused by immunosuppressive therapy (corticosterodis) which follows transplantation. It has been shown that bone loss is most significant during the first 12 months after renal transplantation. Bisphosphonates are drugs that reduce bone loss and are effective in treatment of diseases that affect bone metabolism. There are some studies reporting that bisphosphonates attenuate bone loss in kidney transplant recipients. However, no consensus has been reached on dosage, initiation and duration of the treatment. Aim of this study is to test the effectiveness of low dose pamidronate in bone loss prevention during the first year after renal transplantation. ----- Patients and methods: In this study 35 patients were included after successful renal transplantation in UHC Zagreb. Intervention group (n=19) received two doses of 0.5 mg/kg pamidronate, during first month after transplantation and three months after the first dose. Control group consisted of 17 patients. Bone density was measured by dual energy X-ray absorptiometry (DXA) during hospitalization for renal transplantation, then six and twelve months after renal transplantation. ----- Results: This study confirmed protective effect of low doses pamidronate on bone in the early period after renal transplantation. Pamidronate significantly reduced bone loss on lumbar spine and at Ward's area of femur at six months after renal transplantation. There were no negative effects of pamidronate on graft function. ----- Conclusion: Low dose pamidronate reduces bone loss in the early period after renal transplantation. It is possible to recommend this application scheme for prevention of bone loss. Further studies are needed to answer in which patients application of bisphosphonates would be medically and economically justified.
Keywords
Keywords (english)
Languagecroatian
URN:NBNurn:nbn:hr:105:577372
Study programmeTitle: Biomedicine and Health Sciences
Study programme type: university
Study level: postgraduate
Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstva (doktor/doktorica znanosti, područje biomedicine i zdravstva)
Type of resourceText
Extent95 str.
File originBorn digital
Access conditionsOpen access
Terms of useLicence In copyright icon
Created on2023-05-05 07:08:10