Pediatr Nephrol. 2012 Jan;27(1):3-6. doi: 10.1007/s00467-011-2004-9. Epub 2011 Sep 19.
Recent emphasis on the re-emergence of nutritional rickets has renewed interest in the etiology and therapy of this devastating disorder. At its peak in the 19th and 20th century, rickets was a major area of study for countless experts in childhood disorders and numerous theories abounded as to its cause. These included, among others, infections, confinement or intestinal disturbances, and were largely discarded after the discovery of the role of vitamin D and the importance of ultraviolet irradiation. Once a good explanation had been found for the cause of the disorder and the curative power of vitamin D proven, whether it was obtained from the diet or through exposure to sunlight, there was no apparent need to look any further into the etiology of rickets. But in fact there may have been other contributory factors, recognition of which might have lessened the severity of the disease or hastened recovery. One of these theories might be of particular interest to pediatric nephrologists because it relates to insoluble aluminum-based phosphate binders. Namely, alum used as an adulterant in bread in certain locations may have contributed to metabolic bone disease during the great epidemic of rickets.
最近，人们对营养性佝偻病的再次出现重新产生了兴趣，这促使人们对这种破坏性疾病的病因和治疗方法进行了研究。在 19 世纪和 20 世纪佝偻病的高峰期，它是无数儿童疾病专家研究的主要领域，关于其病因的理论层出不穷。这些理论包括感染、监禁或肠道紊乱等，在发现维生素 D 的作用和紫外线照射的重要性后，这些理论在很大程度上被摒弃了。一旦找到了这种疾病的病因和维生素 D 的治疗作用的合理解释，并证明其无论是来自饮食还是通过阳光照射获得，那么就没有明显的必要进一步探究佝偻病的病因了。但事实上，可能还有其他促成因素，如果能够认识到这些因素，可能会减轻疾病的严重程度或加速康复。其中一个理论可能会引起儿科肾脏病学家的特别关注，因为它与不溶性含铝磷酸盐结合剂有关。具体来说，在佝偻病的大流行期间，在某些地区用于面包的添加剂明矾可能导致代谢性骨病。
