Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55901, USA.
Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55901, USA; Department of Biochemistry and Molecular Biology, Mayo Clinic, 200 First Street SW, Rochester, MN 55901, USA.
Endocrinol Metab Clin North Am. 2017 Dec;46(4):983-1007. doi: 10.1016/j.ecl.2017.07.008. Epub 2017 Sep 29.
Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are associated with abnormalities in bone and mineral metabolism, known as CKD-bone mineral disorder. CKD and ESRD cause skeletal abnormalities characterized by hyperparathyroidism, mixed uremic osteodystrophy, osteomalacia, adynamic bone disease, and frequently enhanced vascular and ectopic calcification. Hyperparathyroidism and mixed uremic osteodystrophy are the most common manifestations due to phosphate retention, reduced concentrations of 1,25-dihydroxyvitamin D, intestinal calcium absorption, and negative calcium balance. Treatment with 1-hydroxylated vitamin D analogues is useful.
慢性肾脏病（CKD）和终末期肾病（ESRD）与骨和矿物质代谢异常有关，被称为 CKD-矿物质骨异常。CKD 和 ESRD 引起的骨骼异常的特征为甲状旁腺功能亢进、混合性尿毒症性骨营养不良、骨软化症、动力缺失性骨病，并且常常伴有血管和异位钙化增强。甲状旁腺功能亢进和混合性尿毒症性骨营养不良是最常见的表现，这是由于磷酸盐潴留、1,25-二羟维生素 D 浓度降低、肠道钙吸收和负钙平衡所致。用 1 羟化维生素 D 类似物治疗是有用的。
