慢性腎臟病患中鈣磷異常的流行病學

The Epidemiology of Calcium-Phosphate Dysregulation in CKD Patients

林彥仲(Yen-chung Lin) ； 陳錫賢(Hsi-Hsien Chen) ； 吳麥斯(Mai-Szu Wu)

《腎臟與透析》 27卷3期 (2015/09) Pp. 103-106

https://doi.org/10.6340/KD.2015.27(3).01

摘要

台灣ESRD發生率排世界第一，警覺性不足是可能的原因，而慢性腎臟病－骨病變（CKD-MBD），是CKD常見的併發症，但因症狀輕微，常被忽略。而CKD-MBD包含血管鈣化，可能參與冠狀動脈硬化的過程，增加病患心血管疾病，更令人擔心。根據2009 KDIGO準則，建議控制副甲狀腺激素在正常標準值二到九倍，但在台灣腎臟醫學會資料庫，血液透析有超過半數的副甲狀腺為異常，比國外的統計為高。而副甲狀腺低下的病患，經校正之後，總死亡率較高，達到統計上顯著意義。

關鍵字

慢性腎臟病－骨病變 ； 血管鈣化 ； 低週轉性骨病變 ； 副甲狀腺激素 ； 鈣磷沉積

並列摘要

Taiwan ranks in the first place of ESRD incidence over the world. Low awareness of CKD could be one of the reasons. CKD-MBD is a common complication but patients usually neglect because of mild symptoms. CKD-MBD includes vascular calcification, which may participate in the formation of atherosclerosis or increasing cardiovascular disease. It is the most worrisome situations. According to 2009 KDIGO guidelines, intact-PTH is suggested to control within two to nine times of normal value. However, in TWRDS 2005~2012 database, more than half of hemodialysis patients had abnormal PTH level, higher than the report from the COSMOS study. Among those with low PTH level ＜ 150 pg/mL, after adjusting for age, sex, diabetes, kt/V, hazard ratio of mortality was significantly higher than those with normal or higher PTH levels.

並列關鍵字

CKD-MBD ； arterial calcification ； low turn-over bone disorder ； parathyroid hormone ； calcium phosphate product