慢性肾脏病非透析患者矿物质骨代谢紊乱的研究  

Investigation of mineral bone disorders in pre-dialysis patients with chronic kidney disease

作　　者：李贺[1] 代文迪[1] 刘文虎[1] 

机构地区：[1]首都医科大学附属北京友谊医院肾内科,北京100050

出　　处：《中国医师杂志》2016年第2期195-198,共4页Journal of Chinese Physician

基　　金：北京市科学技术委员会科技计划重大项目（D131100004713001）

摘　　要：目的了解慢性肾脏病2～5期非透析患者矿物质代谢异常及影响25羟基维生素D[25（OH）VitD]水平的因素。方法选取CKD2～5期患者365例，分析各期矿物质骨代谢紊乱发生率及影响25（OH）VitD水平的因素。结果CKD2期即出现低钙血症，高磷血症，继发性甲状旁腺功能亢进及25（OH）VitD水平的下降，多元线性回归分析发现25（OH）VitD与矫正钙水平（P=0．002），是否应用钙剂（P=0．038），是否应用骨化三醇（P=0．049）独立相关（R方=0．360，P=0．000）。结论CKD2期即出现钙磷代谢紊乱及25（OH）VitD水平的下降，应早期干预钙磷代谢紊乱，更应重视25（OH）VitD缺乏与不足的管理。Objective To investigate mineral bone metabolic conditions of pre-dialysis patients with chronic kidney disease （CKD） , and obtain useful information about the management and treatment of CKD. Methods The levels of serum calcium, phosphate, 25-HydroxyvitaminD [ 25 （OH） VitD ], and intact parathyroid hormone （iPTH） were compared. Then a correlation analysis was performed for 25 （OH） VitD, Results Hypocalcemia, hyperphosphatemia, secondary hyperparathyroidism and inadequate of 25 （OH） VitD appeared early in CKD2. Deficiency of 25 （OH）VitD was widespread in CKD2 - 5. Multiple linear regression analysis showed that 25 （OH） VitD was independently associated with adjusted level of cal- cium （ P = 0. 002）, application of calcium carbonate （ P = 0. 038）, and application of calcitriol （ P = 0. 049） （ R square = 0. 360, P = 0. 000）. Conclusions Mineral bone disorder emerges early in CKD2. More attention should be paid to the management of 25（OH） VitD.

关 键 词：肾疾病/代谢 矿物质/代谢 维生素D/代谢 

分 类 号：R692[医药卫生—泌尿科学]