Relationship between disease stage and renal function in bisphosphonate-related osteonecrosis of the jaw
김윤호, 박한결, 최나래, 김성원, 김규천, 황대석, 김용덕, 신상훈, 김욱규,
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김윤호 ( Kim Yun-Ho ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery
박한결 ( Park Han-Kyul ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery
최나래 ( Choi Na-Rae ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery
김성원 ( Kim Seong-Won ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery
김규천 ( Kim Gyoo-Cheon ) - Pusan National University School of Dentistry Department of Oral Anatomy
황대석 ( Hwang Dae-Seok ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery
김용덕 ( Kim Yong-Deok ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery
신상훈 ( Shin Sang-Hun ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery
김욱규 ( Kim Uk-Kyu ) - Pusan National University School of Dentistry Department of Oral and Maxillofacial Surgery
KMID : 0355620170430010016
Abstract
Objectives: Bisphosphonate is the primary cause of bisphosphonate-related osteonecrosis of the jaw (BRONJ). Bisphosphonates are eliminated from the human body by the kidneys. It is anticipated that bisphosphonate levels in the body will increase if the kidney is in a weak state or if there is systemic disease that affects kidney function. The aim of this study was to analyze the relevance of renal function in the severity of BRONJ.
Materials and Methods: Ninety-three patients diagnosed with BRONJ in Pusan National University Dental Hospital from January 2012 to December 2014 were included in this study. All patients underwent a clinical exam, radiographs, and serologic lab test, including urine analysis. The patient’s medical history was also taken, including the type of bisphosphonate drug, the duration of administration and drug holiday, route of administration, and other systemic diseases. In accordance with the guidelines of the 2009 position paper of American Association of Oral and Maxillofacial Surgeons, the BRONJ stage was divided into 4 groups, from stage 0 to 3, according to the severity of disease. IBM SPSS Statistics version 21.0 (IBM Co., USA) was used to perform regression analysis with a 0.05% significance level.
Results: BRONJ stage and renal factor (estimated glomerular filtration rate) showed a moderate statistically significant correlation. In the group with higher BRONJ stage, the creatinine level was higher, but the increase was not statistically significant. Other factors showed no significant correlation with BRONJ stage. There was a high statistically significant correlation between BRONJ stage and ‘responder group’ and ‘non-responder group,’ but there was no significant difference with the ‘worsened group.’ In addition, the age of the patients was a relative factor with BRONJ stage.
Conclusion: With older age and lower renal function, BRONJ is more severe, and there may be a decrease in patient response to treatment.
키워드
Osteomyelitis; Bisphosphonate-associated osteonecrosis of the jaw; Chronic renal diseases
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