Salusky I B, Ramirez J A, Goodman W G
University of California at Los Angeles School of Medicine.
Curr Opin Nephrol Hypertens. 1993 Jul;2(4):580-7. doi: 10.1097/00041552-199307000-00008.
Secondary hyperparathyroidism remains the predominant histologic lesion in pediatric patients undergoing regular dialysis, but recent evidence indicates that the regulation of parathyroid hormone secretion by calcium does not differ substantially between patients with osteitis fibrosa and subjects with normal renal function. Growth retardation and skeletal deformities are major findings in pediatric patients with renal osteodystrophy, and alterations in vitamin D metabolism and insulin-like growth factor almost certainly contribute to these findings. Avoidance of aluminum-containing medications and the introduction of intermittent calcitriol therapy provide newer approaches to the effective management of secondary hyperparathyroidism in pediatric patients with end-stage renal disease.
继发性甲状旁腺功能亢进仍然是接受常规透析的儿科患者主要的组织学病变，但最近的证据表明，纤维性骨炎患者与肾功能正常者相比，钙对甲状旁腺激素分泌的调节并无显著差异。生长发育迟缓与骨骼畸形是患有肾性骨营养不良的儿科患者的主要表现，维生素D代谢及胰岛素样生长因子的改变几乎肯定与这些表现有关。避免使用含铝药物以及采用间歇性骨化三醇疗法为有效治疗终末期肾病儿科患者的继发性甲状旁腺功能亢进提供了新方法。
