Fujii Hideki
Division of Nephrology and Kidney Center, Kobe University Graduate School of Medicine, Kobe, Japan.
Ther Apher Dial. 2018 Jun;22(3):236-241. doi: 10.1111/1744-9987.12679. Epub 2018 Apr 30.
Although parathyroid hormone is known to be related with calcium and phosphate metabolism, it has been also reported to have several effects on the cardiovascular system including heart and vessels. However, the detailed pathophysiological mechanisms remain unclear. Clinical studies have indicated that parathyroid hormone is associated with cardiovascular events and mortality not only in patients with chronic kidney disease but also in those without chronic kidney disease. As a possible mechanism, it is thought that parathyroid hormone is associated with the renin-angiotensin-aldosterone system and has direct effects on the cardiovascular system. Therefore, we should pay attention to not only the control of serum phosphate and calcium levels but also the control of serum parathyroid hormone levels, especially in patients with chronic kidney disease.
尽管已知甲状旁腺激素与钙和磷代谢有关，但也有报道称它对包括心脏和血管在内的心血管系统有多种影响。然而，具体的病理生理机制仍不清楚。临床研究表明，甲状旁腺激素不仅与慢性肾脏病患者的心血管事件和死亡率有关，而且与无慢性肾脏病患者的心血管事件和死亡率也有关。作为一种可能的机制，人们认为甲状旁腺激素与肾素-血管紧张素-醛固酮系统有关，并对心血管系统有直接影响。因此，我们不仅应关注血清磷和钙水平的控制，还应关注血清甲状旁腺激素水平的控制，尤其是在慢性肾脏病患者中。
