Mace Maria Lerche, Ølgaard Klaus, Lewin Eva
Ugeskr Laeger. 2018 May 21;180(21).
Calcium and phosphate levels are regulated by a complex interplay between parathyroid hormone (PTH), calcitriol, fibroblast growth factor 23 (FGF23) and its co-receptor αKlotho. Kidney failure causes severe disturbances in the mineral and bone homeostasis resulting in phosphate retention, hypocalcaemia and high plasma levels of FGF23 and PTH, and the patients develop fragile bones and vascular calcifications. Today's treatments aim to lower the levels of phosphate and PTH. Future studies need to clarify, if lowering the FGF23 level or supplementation with αKlotho will improve survival for patients with chronic kidney disease.
钙和磷水平受甲状旁腺激素(PTH)、骨化三醇、成纤维细胞生长因子23(FGF23)及其共受体α-klotho之间复杂的相互作用调节。肾衰竭会导致矿物质和骨稳态严重紊乱,导致磷潴留、低钙血症以及血浆FGF23和PTH水平升高,患者会出现骨骼脆弱和血管钙化。目前的治疗旨在降低磷和PTH水平。未来的研究需要明确,降低FGF23水平或补充α-klotho是否会改善慢性肾病患者的生存率。