Klinikum Coburg GmbH, Department of Nephrology, Coburg, Germany.
Princess Margaret Hospital, Kowloon West Cluster Hospital Authority, Kowloon, Hong Kong SAR, China.
Kidney Res Clin Pract. 2014 Mar;33(1):3-8. doi: 10.1016/j.krcp.2013.11.004. Epub 2014 Feb 3.
Over the last 15 years, our knowledge and understanding of the underlying mechanisms involved in the regulation of calcium and phosphate homeostasis in chronic kidney disease have advanced dramatically. Contrary to general opinion in the 20(th) century that moderate hypercalcemia and hyperphosphatemia were acceptable in treating secondary hyperparathyroidism, the calcium and phosphate load is increasingly perceived to be a major trigger of vascular and soft tissue calcification. The current treatment options are discussed in view of historical developments and the expectations of the foreseeable future, focusing on the early treatment of hyperphosphatemia. At present, we lack indisputable evidence that active intervention using currently available drugs is of benefit to patients in chronic kidney disease stages 3 and 4.
在过去的 15 年中，我们对慢性肾脏病中钙和磷稳态调节所涉及的潜在机制的认识和理解有了显著的进步。与 20 世纪普遍认为适度高钙血症和高磷血症可以接受治疗继发性甲状旁腺功能亢进症的观点相反，钙和磷负荷被认为是血管和软组织钙化的主要触发因素。目前的治疗选择是根据历史发展和可预见的未来进行讨论的，重点是早期治疗高磷血症。目前，我们缺乏确凿的证据表明使用现有药物进行积极干预对慢性肾脏病 3 期和 4 期患者有益。
