Hruska K A
Renal Division, Washington University, St Louis, MO, USA.
Baillieres Clin Endocrinol Metab. 1997 Apr;11(1):165-94. doi: 10.1016/s0950-351x(97)80585-x.
Renal osteodystrophy is a general complication of chronic renal failure and end-stage renal disease. The nature of renal osteodystrophy has changed since osteomalacia due to aluminum intoxication has become less prevalent. Osteomalacia has been replaced by the adynamic bone disorder. Suppression of osteitis fibrosa, calcitrol and control of secondary hyperparathyroidism has been shown to produce the adynamic bone disorder. Thus, many other factors besides secondary hyperparathyroidism and calcitrol deficiency contribute to the pathogenesis of renal osteodystrophy. Some of these factors, according to our current state of knowledge, are discussed in this chapter along with the presentation and treatment of renal osteodystrophy.
肾性骨营养不良是慢性肾衰竭和终末期肾病的常见并发症。自从铝中毒所致的骨软化症发病率降低以来，肾性骨营养不良的性质已发生改变。骨软化症已被动力缺乏性骨病所取代。已有研究表明，抑制纤维性骨炎、骨化三醇以及控制继发性甲状旁腺功能亢进会导致动力缺乏性骨病。因此，除继发性甲状旁腺功能亢进和骨化三醇缺乏外，许多其他因素也参与了肾性骨营养不良的发病机制。根据我们目前的认知水平，本章将对其中一些因素以及肾性骨营养不良的临床表现和治疗进行讨论。
