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[慢性肾脏病中的血管钙化]

[Vascular calcification in chronic kidney disease].

作者信息

Cozzolino Mario, Missaglia Elena, Ortiz Alberto, Bellasi Antonio, Adragao Teresa, Apostolous Theofanis, Vescovo Giorgio, Gallieni Maurizio

机构信息

Dipartimento di Medicina, Chirurgia e Odontoiatria, Ospedale S. Paolo, Milano.

出版信息

Recenti Prog Med. 2010 Nov;101(11):442-52.

Abstract

Patients affected by chronic kidney disease (CKD) suffer by secondary hyperparathyroidism and hyperphosphatemia. The new KDIGO guidelines identify a new definition in CKD-MBD (Mineral Bone Disorder), in which vascular calcification plays a central role. In fact, CKD patients that present vascular calcification have highest risk of cardiovascular morbility and mortality. Recently, it has been elucidated that the control of phosphate is one of the major problems for the nephrology community. Furthermore, new markers, such as FGF-23, have been identified as inducers of vascular calcification and cardiovascular disease in CKD. Therefore, the use of calcium-free phosphate-binders may reduce the risk of cardiovascular disease by reducing both serum phosphate and FGF-23 levels.

摘要

慢性肾脏病(CKD)患者会遭受继发性甲状旁腺功能亢进和高磷血症的折磨。新的KDIGO指南确定了慢性肾脏病-矿物质和骨异常(CKD-MBD)的新定义,其中血管钙化起着核心作用。事实上,出现血管钙化的CKD患者发生心血管疾病和死亡的风险最高。最近已经阐明,控制磷酸盐是肾脏病学界的主要问题之一。此外,新的标志物,如成纤维细胞生长因子23(FGF-23),已被确定为CKD中血管钙化和心血管疾病的诱导因素。因此,使用无钙磷结合剂可能通过降低血清磷酸盐和FGF-23水平来降低心血管疾病的风险。

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