生理性維生素D於腎臟病的運用

Role of Nutritional Vitamin-D in Chronic Kidney Disease

劉文治(Wen-Chih Liu) ； 何永和(Yungh-Ho Ho) ； 黃錫培(His-Pei Huang) ； 楊麗琼(Lai-King Yeung) ； 盧國城(Kuo-Cheng Lu)

《腎臟與透析》 27卷3期 (2015/09) Pp. 124-128

https://doi.org/10.6340/KD.2015.27(3).06

摘要

慢性腎臟病的進展常伴隨有活性維生素D的缺乏。近年來研究顯示，有別於傳統的觀念，在腎臟以外的器官，仍能將25(OH)D轉變為1,25(OH)_2D。更甚者，在慢性腎臟病各階段，普遍存有25(OH)D缺乏。在慢性腎臟病維生素D的缺乏，將增加心臟血管疾病及感染的風險，適當補充生理性維生素D，在慢性腎臟病人的發炎反應及免疫方面有重要角色，且其能降低病人罹病率及死亡率。本篇文章探討在慢性腎臟病補充生理性維生素D的重要性及相關文獻的綜合整理。

關鍵字

生理性維生素D ； 活性維生素D ； 1α－羥化酶 ； 骨骼重塑

並列摘要

The development of CKD is accompanied by a progressive decrease in the ability to produce 1,25-dihydroxyvitamin D. Recent evidence suggests that extrarenal conversion of 25-hydroxyvitamin D to 1,25-dihydroxyvitamin D may have significant biological roles beyond those traditionally ascribed to vitamin D. Furthermore, low 25-hydroxyvitamin D levels are common in patients with all stages of CKD. Vitamin D has been implicated in all-cause and cardiovascular mortality risk, as well as infectious mortality risk, in CKD. Thus, achievement and maintenance of adequate vitamin D status may have a role in managing inflammation and immunity, and ultimately, reducing morbidity and mortality in patients with CKD. This article focuses on the role of nutritional vitamin D replacement in CKD and aims to review vitamin D biology and summarize the existing literature regarding nutritional vitamin D replacement in these populations.

並列關鍵字

cholecalciferol ； 1,25-dihydroxyvitamin D ； 1α-hydroxylase ； bone remodeling