Skelettale Komplikationen bei chronischer Niereninsuffizienz und nach Nierentransplantation

Zusammenfassung

Die chronische Niereninsuffizienz ist weltweit eine Erkrankung mit zunehmender Prävalenz, hoher Morbiditätsrate, verminderter Lebensqualität und steigender Mortalität. Neben arterieller Hypertonie, Proteinurie, metabolischer Azidose, Anämie und einer gesteigerten kardiovaskulären Mortalität stellen Knochenstoffwechselstörungen, für deren exakte Differenzierung eine knochenhistologische Untersuchung unabdingbar ist, eine obligate Komplikation dar. Weiterhin besteht im Rahmen des chronischen Entzündungsprozesses bei langjähriger Dialyse die Gefahr der Entwicklung eine ß2Amyloisose mit schmerzhaften Weichteil- und Knochenmanifestationen. Schließlich stellen Knochenschmerzen nach Nierentransplantation als Folge einer immunsuppressiven Therapie eine differenzialdiagnostische und therapeutische Herausforderung dar.

Abstract

Chronic kidney disease is an increasing international public health problem. It is strongly related to high morbidity, loss of quality of life and increasing mortality. Beside hypertension, proteinuria, anaemia and extraskeletal calcifications systemic complications comprise disturbances in bone turnover as well. Precise identification of bone turnover disturbances requires bone histomorphometry. Furthermore, dialysis-related ß2 amyloidosis is associated with various osteoarticular lesions. Finally bone pain after renal transplantation as a consequence of immunosuppressive therapy poses a diagnostic and therapeutic challenge.

Schlüsselwörter

chronische Niereninsuffizienz - renale Osteodystrophie - Calcineurininhibitor induzierter Schmerz

Key words

chronic kidney disease - renal osteodystrophy - calcineurin-induced pain syndrome

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