活性维生素D在慢性肾脏病-矿物质和骨异常中的应用

Clinical application of active vitamin D in chronic kidney disease-mineral and bone disorder

矿物质和骨异常(mineral and bone disorder,MBD)是慢性肾脏病(chronic kidney disease,CKD)的常见并发症之一,是CKD患者致残和致死的重要原因之一。维生素D缺乏是CKD-MBD发生、发展的重要原因。合理应用活性维生素D(包括骨化三醇或其他维生素D类似物),使血钙、磷和全段甲状旁腺素(intact parathyroid hormone,iPTH)维持在理想范围,可有效防治继发性甲状旁腺功能亢进症、血管钙化、肾性骨营养不良和骨质疏松等,改善CKD患者的生存质量,降低发病率和病死率。

Mineral and bone disorder（ MBD） is one of the common complications of chronic kidney disease（ CKD）,and is an important causes for patient＇s disability and mortality. The deficiency of vitamin D plays a key role in the development and progression of CKD-MBD. Appropriate administration of calcitriol or other vitamin D analogs,which maintains serum calcium,phosphate and intact parathyroid hormone（ iPTH） in the optimal ranges,can effectively prevent and treat secondary hyperparathyroidism（ SHPT）,vascular calcification,renal osteodystrophy,osteoporosis,and improve quality of life,decrease the morbidity and mortality in CKD patients.