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维生素D是钙、磷及骨代谢的重要调节激素,在血液透析患者中使用维生素D可上调维生素D受体,控制继发性甲状旁腺功能亢进(SHPT),纠正钙磷失衡。各国指南都推荐使用维生素D作为SHPT的重要治疗手段。但是,不合理的使用维生素D治疗,尤其是活性维生素D及类似物的过早或过量使用,可能增加体内钙磷负荷,心血管系统钙化及心血管事件的发病风险。因此,本文整理各国慢性肾脏病-矿物质和骨异常(CKD-MBD)指南中有关活性维生素D及其类似物治疗SHPT的内容,希望从发挥其有益的治疗作用,减少不良反应的角度,为临床医生治疗SHPT提供更多的参考。
Vitamin D is an important regulator of calcium, phosphorus and bone metabolism, vitamin D in hemodialysis patients can upregulate vitamin D receptors, control of secondary hyperparathyroidism (SHPT), to correct calcium and phosphorus imbalance. National guidelines recommend the use of vitamin D as an important treatment for SHPT. However, inappropriate treatment with vitamin D, especially premature or excessive use of active vitamin D and its analogs, may increase the risk of calcium-phosphorus load, cardiovascular calcification and cardiovascular events in the body. Therefore, in this paper, the contents of active vitamin D and its analogues in the treatment of SHPT in chronic kidney disease - mineral and bone anomalies (CKD-MBD) guidelines of various countries are summarized. In the hope of exerting beneficial therapeutic effects and reducing adverse reactions, Clinicians to provide more information on the treatment of SHPT.