Cervical Fusion-Requiring Mineral and Bone Disorder Disguised as Osteoporosis in a Chronic Kidney Disease Patient on Hemodialysis: A Case Report
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Bony deformities and fragility fractures in end-stage renal disease (ESRD) patients on long-term hemodialysis can be caused by either osteoporosis or chronic kidney disease- mineral and bone disorder (CKD-MBD). Correct identification of the underlying mecha- nism is critical since the treatment methods differ, and one treatment approach could negatively affect the other. Cervical kyphosis, severe enough to require immediate surgi- cal treatment, can be caused by uncontrolled CKD-MBD, albeit in limited cases. This re- port presents the case of a 61-year-old female with an 11-year history of hemodialysis treatment and severe cervical kyphosis with myelopathy, which required 2-stage spinal surgeries. Our report calls for a careful diagnostic approach in ESRD patients with skele- tal disorders, the points to consider before calcium replacement, and early detection of fragility fractures in them. Moreover, early mobilization and weight-bearing after the surgical procedure may lead to better neurological and functional improvements.
Abstract
Bony deformities and fragility fractures in end-stage renal disease (ESRD) patients on long-term hemodialysis can be caused by either osteoporosis or chronic kidney disease- mineral and bone disorder (CKD-MBD). Correct identification of the underlying mecha- nism is critical since the treatment methods differ, and one treatment approach could negatively affect the other. Cervical kyphosis, severe enough to require immediate surgi- cal treatment, can be caused by uncontrolled CKD-MBD, albeit in limited cases. This re- port presents the case of a 61-year-old female with an 11-year history of hemodialysis treatment and severe cervical kyphosis with myelopathy, which required 2-stage spinal surgeries. Our report calls for a careful diagnostic approach in ESRD patients with skele- tal disorders, the points to consider before calcium replacement, and early detection of fragility fractures in them. Moreover, early mobilization and weight-bearing after the surgical procedure may lead to better neurological and functional improvements.
참고문헌 (10)
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