Division of Renal Medicine, Brigham and Women's Hospital, Boston, MA.
Division of Nephrology, Department of Medcine, New York Medical College, Valhalla, NY.
Semin Nephrol. 2019 Jan;39(1):41-56. doi: 10.1016/j.semnephrol.2018.10.004.
Dysregulated mineral metabolism is a nearly universal sequalae of acute kidney injury (AKI). Abnormalities in circulating mineral metabolites observed in patients with AKI include hypocalcemia, hyperparathyroidism, hyperphosphatemia, decreased vitamin D metabolite levels, and increased fibroblast growth factor 23 levels. We review the pathophysiology of dysregulated mineral metabolism in AKI with a focus on calcium, phosphate, parathyroid hormone, and vitamin D metabolites. We discuss how mineral metabolite levels can serve as novel prognostic markers for incident AKI and other related outcomes in various clinical settings. Finally, we discuss how vitamin D metabolites potentially could be used as novel therapeutic agents for AKI prevention and treatment.
矿物质代谢紊乱是急性肾损伤(AKI)几乎普遍存在的后遗症。AKI 患者循环中矿物质代谢物的异常包括低钙血症、甲状旁腺功能亢进症、高磷血症、维生素 D 代谢物水平降低和成纤维细胞生长因子 23 水平升高。我们重点讨论了 AKI 中矿物质代谢紊乱的病理生理学,包括钙、磷、甲状旁腺激素和维生素 D 代谢物。我们讨论了矿物质代谢物水平如何作为不同临床环境中 AKI 事件和其他相关结局的新型预后标志物。最后,我们讨论了维生素 D 代谢物如何可能作为 AKI 预防和治疗的新型治疗药物。