慢性肾脏病患者骨代谢标志物的临床意义

Clinical significance of bone turnover biomarkers in patients with chronic kidney disease

慢性肾脏病矿物质和骨异常(chronic kidney disease-mineral and bone disorder,CKD-MBD)是慢性肾脏病(chronic kidney disease,CKD)的常见并发症之一,引起矿物质代谢紊乱、骨质疏松、骨折及血管钙化的发生,严重影响患者预后。因此,早期的筛查、诊断及治疗十分重要。骨活检因其有创性而未能在临床上广泛开展,CKD-MBD的诊断主要依赖于骨代谢标志物(bone turnover biomakers,BTMs)的测定。既往研究表明,BTMs是评估CKD患者骨转换及患者预后的有力证据。本文就BTMs进行综述,为CKD-MBD的临床诊断与预后评估提供参考。

Chronic kidney disease-mineral and bone disorder(CKD-MBD)is one of the most common complications of chronic kidney disease(CKD).It may cause mineral disorder,osteoporosis,fracture and vascular calcification and affect the prognosis of patients.Thus it is imperative to screen,diagnose and treat CKD-MBD in an early stage.Bone biopsy is not applied extensively due to its invasiveness.Currently a definite diagnosis of CKD-MBD is dependent upon measuring the levels of bone turnover biomarkers(BTMs).Many recent studies have demonstrated that BTMs are valuable for assessing bone turnover and patient prognosis.This review focused upon the clinical significance of BTMs in CKD patients and provided references for clinical diagnosis and prognostic assessment of CKD-MBD.