Dabbagh S
Department of Pediatrics, Children's Hospital of Michigan, Detroit 48201, USA.
Curr Opin Pediatr. 1998 Apr;10(2):190-6. doi: 10.1097/00008480-199804000-00013.
Secondary hyperparathyroidism develops in most patients with chronic renal failure, and is associated with the histologic finding of osteitis fibrosa cystica. The disease is characterized by growth failure and severe bone deformities in children, especially the very young. The pathogenesis of renal osteodystrophy is related to phosphate retention, and its effect on calcium and calcitriol metabolism, in addition to roles played by metabolic acidosis, cytokines, and degradation of parathyroid hormone. Treatment includes restriction of dietary phosphorous intake, phosphate binders, and use of active metabolites of vitamin D.
大多数慢性肾衰竭患者会发生继发性甲状旁腺功能亢进，且与纤维性骨炎的组织学表现相关。该疾病的特征为儿童生长发育迟缓及严重的骨骼畸形，尤其是年幼患儿。肾性骨营养不良的发病机制与磷潴留及其对钙和骨化三醇代谢的影响有关，此外还涉及代谢性酸中毒、细胞因子及甲状旁腺激素降解所起的作用。治疗措施包括限制饮食中磷的摄入量、使用磷结合剂以及应用维生素D的活性代谢产物。
