Relevant Factors of Hemodialytic Patient's Bone Mineral Density and Physical Pain

• Main Authors: Kuo, Li Lan, 郭俐蘭
• Other Authors: Tsai, Wei Her, Ph. D.
• Format: Others
• Language: zh-TW
• Published: 2008
• Online Access: http://ndltd.ncl.edu.tw/handle/81160795392268559211

碩士 === 國立台北護理學院 === 醫護管理研究所 === 96 === It has been reported that the population of hemodialytic patients was approximately 1.8 million in the world, and the rate of increasing renal disease was 7-8% per year. In 2004, the incidence and prevalence of ESRD (End-Stage Renal Disease) in Taiwan were the highest in the world. The complications, especially renal osteopathy, due to long term hemodialysis were worried in addition to the increasing cost. The danger of motality included osteoporosis, fragile fracture and physical pain due to renal osteopathy. However, investigations concerning the relationship between bone density of hemodialytic patients and factors influencing physical pain seem still inadequate at present. The author tried to investigate the relationship between factors influencing bone density and physical pain among hemodialytic patients which may be useful to clinical care and health policies. The mean bone density of the hemodialytic patients in the investigation was-2.6(SD=±1.1) with 52.7% reaching the criteria of osteoporosis(T-score＜-2.5). The estimation by ANOVA and Scheffe revealed that bone density had significant relationship with age and total hemodialytic months but no significant relationship with BMI, seral parathyroid hormone and physical activity. Multiple regression analysis revealed the important predicting factors of bone density included: age, sex, serum calcium, phosphorus, calcium–phosphorus product and hepatitis C, Adj-R2 was 23.1%. Another ways, lumbago and back pain were the major symptoms and accounted for 35.8% of physical pain. Physical pain index had significant relationship with occupation and bone density included. The investigation suggests the medical staffs should pay much attention to the balance of calcium and phosphate in addition to the subjectively physical pain of the patients, bone care and transferring for the treatment of osteoporosis. Moreover, it is important to control Hepatitis C in hemodialysis centers and to investigate the relationship between Hepatitis C and bone density. It is also critical to provide health education and assistance to the falling-down of hemodialytic patients and to provide them safety advices and protection methods at home as well.