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急性肾损伤中的矿物质代谢紊乱。

Dysregulated Mineral Metabolism in AKI.

机构信息

Division of Renal Medicine, Brigham and Women's Hospital, Boston, MA.

Division of Nephrology, Department of Medcine, New York Medical College, Valhalla, NY.

出版信息

Semin Nephrol. 2019 Jan;39(1):41-56. doi: 10.1016/j.semnephrol.2018.10.004.

Abstract

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.

摘要

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。

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