活性维生素D及其类似物在CKD-MBD中的应用  

The use of active vitamin D and its analogues in chronic kidney disease-mineral and bone disorder

作　　者：周加军 张凌[2] ZHOU Jia-Jun;ZHANG Lin(Blood Purification Center, The First Affiliated Hospital of Wannan Medical College, Wuhu 241000, China;Department of Nephrology, China-Japan Friendship Hospital Beijing 100029, China)

机构地区：[1]皖南医学院第一附属医院血液净化中心,北京100029 [2]中日友好医院肾内科,芜湖241000

出　　处：《中国血液净化》2018年第6期370-373,共4页Chinese Journal of Blood Purification

基　　金：北京市科委首都临床特色应用研究与成果推广;首都特色资助项目;项目名称:甲状旁腺切除术对维持性血液透析患者心血管钙化评价的前瞻队列研究;课题编号:Z151100004015112

摘　　要：慢性肾脏病-矿物质和骨代谢异常(chronic kidney disease-mineral and bone disorder,CKDMBD)是慢性肾脏病(chronic kidney disease,CKD)患者主要的并发症之一,目前CKD-MBD治疗手段主要包括:磷结合剂、活性维生素D及其类似物、拟钙剂等药物治疗以及甲状旁腺手术治疗。其中,活性维生素D及其类似物是最为常见的治疗药物,可以降低甲状旁腺激素(parathyroid hormone,PTH),改善骨质疏松和高转运骨病的骨损害,在临床上应用广泛,但使用不当也会导致高钙、高磷血症及加重血管钙化发展,为了更合理的使用该类药物,本文结合2017年KDIGO的CKD-MBD指南更新并就活性维生素D及其类似物在CKD-MBD的治疗进展进行介绍。Chronic kidney disease-mineral and bone disorder（CKD-MBD） is one of the major complications and one of the major death causes in CKD patients. Currently, the treatment of CKD-MBD mainly includes phosphorus binding agent, active vitamin D and its analogues, calcimimetics and parathyroidectomy.Active vitamin D and its analogues are widely used clinically, which can reduce parathyroid hormone level and alleviate bone damage of osteoporosis and high transport bone disease. However, inappropriate use of these medications may cause hypercalcemia, hyperphosphatemia and aggravation of vascular calcification.This article introduces recent progresses in the treatment of CKD-MBD using active vitamin D and its analogues as well as the renewal of KDIGO guide 2017 for CKD-MBD.

关 键 词：活性维生素D 骨化三醇 帕立骨化醇 慢性肾脏病-矿物质和骨代谢异常 

分 类 号：R692.5[医药卫生—泌尿科学]