Headley C M
Nephrology Division, Veteran's Administration Medical Center, Memphis, TN, USA.
ANNA J. 1998 Feb;25(1):21-8; quiz 29-30.
Renal osteodystrophy is frequently seen in patients with end stage renal disease. Osteitis fibrosa associated with secondary hyperparathyroidism is often diagnosed. Treatment options vary based on disease severity. Individual patient considerations need to be addressed to determine the best therapeutic plan. Medical management with calcitriol, dietary modifications, and administration of phosphate binders continues to be the best treatment for most patients. Parathyroidectomy should be reserved for patients with complications related to severe irreversible hyperparathyroidism and/or failure of medical management. Total resection of all parathyroid tissue with or without autotransplant is the most common surgery for hyperparathyroid bone disease.
肾性骨营养不良常见于终末期肾病患者。常诊断出与继发性甲状旁腺功能亢进相关的纤维性骨炎。治疗方案因疾病严重程度而异。需要考虑个体患者情况以确定最佳治疗方案。使用骨化三醇进行药物治疗、调整饮食以及使用磷结合剂仍然是大多数患者的最佳治疗方法。甲状旁腺切除术应保留给有与严重不可逆甲状旁腺功能亢进相关并发症和/或药物治疗失败的患者。切除所有甲状旁腺组织（无论是否进行自体移植）是治疗甲状旁腺性骨病最常见的手术。
