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Die Innere Medizin

Erschienen in:

01.10.2007 | Weiterbildung • Zertifizierte Fortbildung

Metabolische Knochenerkrankungen

verfasst von: Prof. Dr. F. Jakob

Erschienen in: Die Innere Medizin | Ausgabe 10/2007

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Zusammenfassung

Osteomalazie ist bedingt durch verminderte Vitamin-D-Rezeptor- (VDR-) Wirkung und Kalziummangel mit gestörter Knochenmineralisierung. Ursachen sind mangelnde Sonnenexposition, niedrige Zufuhr von Kalzium und Vitamin D₃, Malabsorption, reduzierte D-Hormonaktivierung bei Niereninsuffizienz, seltene Störungen des VDR-Signalweges und Phosphatverlustsyndrome. Leitsymptome sind Knochenschmerzen, Muskelkrämpfe, und im Alter erhöhte Sturzinzidenz. Die Therapie besteht in Vitamin D₃ und Kalzium, bei nachgewiesenem Mangel auch im Ersatz von D-Hormon und Phosphat.

Osteoporose ist charakterisiert durch vermehrte Knochenbrüchigkeit bei geringer Krafteinwirkung. Die Indikation zu Diagnostik und Therapie wird gestellt durch die Bestimmung des absoluten Frakturrisikos mittels Knochendichte, Alter, Geschlecht und individueller Risikofaktoren. Körperliches Training, Sturzintervention und Medikamente können das Frakturrisiko bis ins Alter substantiell senken. Sekundäre Osteoporosen erfordern die kausale Therapie der verursachenden Krankheit und einen kritischen Umgang mit knochenschädlichen Medikamenten.

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Titel: Metabolische Knochenerkrankungen
verfasst von: Prof. Dr. F. Jakob
Publikationsdatum: 01.10.2007
Verlag: Springer-Verlag
Erschienen in: Die Innere Medizin / Ausgabe 10/2007
Print ISSN: 2731-7080
Elektronische ISSN: 2731-7099
DOI: https://doi.org/10.1007/s00108-007-1934-6

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Metabolische Knochenerkrankungen

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