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矿物质代谢紊乱是终末期肾病(ESRD)患者最具挑战性的临床问题之一。从早期阶段开始,慢性肾脏病(CKD)即开始增加成纤维细胞生长因子23(FGF23)的循环浓度,从而引发骨化三醇(1,25-二羟维生素D3)缺乏,降低血清钙浓度,并继发性地升高甲状旁腺激素(PTH)水平。同时,逐渐下降的肾小球滤过率可降低磷酸盐的排泄能力,进一步加剧FGF23过分增多和继发性甲状旁腺功能亢进。随着晚期CKD进展到
Mineral metabolic disorders are one of the most challenging clinical problems in patients with end-stage renal disease (ESRD). From an early stage, chronic kidney disease (CKD) begins to increase the circulating concentration of fibroblast growth factor 23 (FGF23), causing a deficiency of calcitriol (1,25-dihydroxyvitamin D3), lowering serum calcium concentration, And increase parathyroid hormone (PTH) levels secondary. At the same time, the gradual decline of glomerular filtration rate can reduce phosphate excretion, further exacerbating FGF23 over-growth and secondary hyperparathyroidism. As advanced CKD progresses