Kim Hyung Soo, Chung Wookyung, Kim Sejoong
Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Korea.
Electrolyte Blood Press. 2011 Jun;9(1):1-6. doi: 10.5049/EBP.2011.9.1.1. Epub 2011 Jun 30.
Mineral metabolism abnormalities, such as low 1,25-dihydroxyvitamin D (1,25(OH)(2)D) and elevated parathyroid hormone (PTH), are common at even higher glomerular filtration rate than previously described. Levels of 25-hydroxyvitamin D (25(OH)D) show an inverse correlation with those of intact PTH and phosphorus. Studies of the general population found much higher all-cause and cardiovascular (CV) mortality for patients with lower levels of vitamin D; this finding suggests that low 25(OH)D level is a risk factor and predictive of CV events in patients without chronic kidney disease (CKD). 25(OH)D/1,25(OH)2D becomes deficient with progression of CKD. Additionally, studies of dialysis patients have found an association of vitamin D deficiency with increased mortality. Restoration of the physiology of vitamin D receptor activation should be essential therapy for CKD patients.
矿物质代谢异常，如1,25 - 二羟维生素D（1,25(OH)₂D）水平降低和甲状旁腺激素（PTH）升高，在肾小球滤过率比先前描述的更高时也很常见。25 - 羟维生素D（25(OH)D）水平与完整PTH和磷的水平呈负相关。对普通人群的研究发现，维生素D水平较低的患者全因死亡率和心血管（CV）死亡率要高得多；这一发现表明，低25(OH)D水平是无慢性肾脏病（CKD）患者发生CV事件的一个危险因素且具有预测性。随着CKD的进展，25(OH)D/1,25(OH)₂D会变得缺乏。此外，对透析患者的研究发现维生素D缺乏与死亡率增加有关。恢复维生素D受体激活的生理状态应该是CKD患者的基本治疗方法。
