摘要慢性肾脏病-矿物质和骨异常(chronic kidney diseasemineral and bone disorder,CKD-MBD)是尿毒症常见而严重的并发症之一。CKD-MBD可引起皮下组织和肢端动脉的中层钙化及内膜增生导致的皮肤坏死和肢端坏疽,即为钙化防御。现将我们收治的1例维持性血液透析患者发生钙化防御的病例报告如下。
1Cunningham J, Locatelli F, Rodriguez M. Secondary hy- perparathyroidism : pathogenesis, disease progression, and therapeutic options[J]. Clin J Am Soc Nephrol,2011,6 (4) :913-921.
2Block GA,Klassen PS,Lazarus JM,et al. Mineralmetabolism,mortality, and morbidity in maintenance hemodialysis[J]. J Am Soc Nephrol,2004,15(8):2208- 2218.
3Coates T,Kirkland GS,Dymock RB,et al. Cutaneous necrosis from calcific uremic arteriolopathy[J]. Am J Kidney Dis, 1998,32(3) : 384-391.
4National Kidney Foundation. K/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease [J]. Am J Kidney Dis,2003,42 (4 Suppl 3) :Sl-201.
5Slatopolsky E,Brown A,Dusso A. Role of phosphorus in the pathogenesis of secondary hyperparathyroidism[J]. Am J Kidney Dis,2001,37(1 Suppl 2):S54-57.
6Tominaga Y, Matsuoka S, Sato T. Surgical indications and procedures of parathyroidectomy in patients with chronic kidney disease[J]. Ther Apher Dial,2005,9( l ) :44-47.
7Tominaga Y,Uchida K,Haba T,et al. More than 1 000 eases of total parathyroideetomy with forearm autograft for renal hyperparathyroidism[J]. Am J Kidney Dis,2001,38 (4 Suppl 1):S168-171.
8Selye H,Gabbiani G,Strebel R. Sensitization to caIciphy- laxis by endogenous parathyroid hormone[J]. Endocrinol- ogy, 1962,71 (4) : 554-558.
9Nigwekar SU,Wolf M,Sterns RH,et al. Calciphylaxis from nonurcmic causes:a systematic review[J]. Clin J Am Soc Nephrol, 2008,3 (4) : 1139-1143.
10Angelis M,Wong LL,Myers SA,et al. Calciphylaxis in patients on hemodialysis : a prevalence study[J]. Surgery, 1997,122(6) : 1083-1089.