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首页> 外文期刊>Medecine Nucleaire >Chronic kidney disease and vitamin D: The twelve key points
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Chronic kidney disease and vitamin D: The twelve key points

机译：慢性肾脏病和维生素D：十二个关键点

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Vitamin D and calcitriol deficiency and insufficiency are frequently observed in chronic kidney disease (CKD) and dialysis patients (90%). The main consequences are secondary hyperparathyroidism (SHPT), leading to bone mass reduction, fractures, and vascular calcification, and increased mortality rate. Native vitamin D supplementation increases the serum 25-hydroxyvitamin D (25-D) and 1,25-dihydroxyvitamin D (1,25-D) levels, decreases the serum parathyroid hormone (PTH) level, improves hypocalcaemia, and decreases proteinuria and left ventricular hypertrophy. Measurement of 25-D serum levels enables the identification of patients with 25-D insufficiency, even if biological targets are lacking, as well as the verification of vitamin D dosage efficiency. Prescription of calcitriol and analogues helps to increase the serum 1,25-D levels, to treat SHPT and hypocalcaemia, and perhaps to improve the survival rate. Routine serum 1,25-D sampling is not recommended, but it could be useful when treating SHPT with calcitriol and analogues. It would be interesting to undertake randomized control trials comparing native compounds and/or calcitriol or analogues in terms of the hard outcomes in both CKD and dialysis patients. (C) 2015 Elsevier Masson SAS. All rights reserved.
机译：在慢性肾脏病（CKD）和透析患者（90％）中经常观察到维生素D和骨化三醇缺乏和不足。主要后果是继发性甲状旁腺功能亢进症（SHPT），导致骨量减少，骨折和血管钙化，并增加死亡率。补充天然维生素D可增加血清25-羟基维生素D（25-D）和1,25-二羟基维生素D（1,25-D）的水平，降低血清甲状旁腺激素（PTH）的水平，改善低钙血症，并降低蛋白尿和左心室肥大。 25-D血清水平的测量可以识别25-D功能不全的患者，即使缺乏生物学指标，也可以验证维生素D的剂量效率。骨化三醇及其类似物的处方有助于增加血清1,25-D水平，治疗SHPT和低血钙症，并可能提高生存率。不建议使用常规的1,25-D血清取样，但在用骨化三醇和类似物治疗SHPT时可能有用。进行随机对照试验比较CKD和透析患者的硬结局，比较天然化合物和/或骨化三醇或类似物。 （C）2015 Elsevier Masson SAS。版权所有。

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