[Perinatal bone and calcium metabolism in the patient complicated with renal dysfunction.]

Clinical calcium Pub Date : 2019-01-01 DOI:CliCa19016269
Hiroyuki Seki
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Abstract

The incidence of pregnancy complicated with renal dysfunction has tended to increase due to aging and progress in the treatment methods. Generally, pregnancy is allowed only in women with normal renal function and in patients with mild renal insufficiency; therefore, the incidence of osteoporosis and the resulting fragile fracture is rare during pregnancy complicated with renal dysfunction. In recent years, the incidence of pregnancy in dialysis patients and in patients who have undergone kidney transplantation has been increasing due to the progress in treatment methods. Eventually, it has become possible for patients with renal dysfunction to give birth as long as they fulfill certain conditions for pregnancy; however, the rate of preterm births has remained high. The incidence of femoral neck fracture has been about 5 times more in dialysis patients than in healthy individuals; however, the prevention and treatment of osteoporosis in pregnant dialysis patients have been difficult, since many osteoporosis medications are contraindicated in pregnant women and also their pregnancy period is not long due to the higher rate of preterm births.

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[围生期合并肾功能不全患者的骨钙代谢]
随着年龄的增长和治疗方法的进步,妊娠合并肾功能不全的发生率有增加的趋势。一般来说,只有肾功能正常的妇女和轻度肾功能不全的患者才允许怀孕;因此,合并肾功能不全的妊娠期骨质疏松及脆性骨折的发生率较低。近年来,由于治疗方法的进步,透析患者和肾移植患者的妊娠发生率不断上升。最终,肾功能不全的患者只要满足一定的怀孕条件,就有可能分娩;然而,早产率仍然很高。透析患者股骨颈骨折的发生率约为健康人的5倍;然而,妊娠透析患者的骨质疏松症的预防和治疗一直很困难,因为许多骨质疏松症药物是孕妇的禁忌症,而且由于早产率较高,妊娠期不长。
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[Nomenclature on Cell Death, apoptosis and autophagic cell death.] [Perinatal bone and calcium metabolism in the patient complicated with renal dysfunction.] [Fracture management and current concepts related to pregnancy-associated osteoporosis.] [Pharmacological treatment for pregnancy and lactation associated osteoporosis.] [Prevention of osteoporosis during pregnancy and lactation period.]
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