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首页> 外文期刊>Journal of nephrology. >Effects of vitamin D on parathyroid hormone and clinical outcomes in peritoneal dialysis: a narrative review
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Effects of vitamin D on parathyroid hormone and clinical outcomes in peritoneal dialysis: a narrative review

机译：维生素D对腹膜透析中甲状旁腺激素和临床结局的影响：叙事回顾

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摘要

Vitamin D deficiency is very prevalent in dialysis and peritoneal dialysis (PD) patients show lower levels of cholecalciferol (25(OH)D-3) than hemodialysis patients. We conducted a systematic narrative review to assess the effects of vitamin D therapy on control of secondary hyperparathyroidism and clinical outcomes induced by vitamin D pleiotropic effects. Medline database was searched for cohort and intervention studies reporting data on vitamin D (all sterols including synthetic analogs) and peritoneal dialysis without language restriction. Two authors independently extracted data. Twenty-nine observational and eleven interventional studies were identified for inclusion (1,036 subjects). PTH levels decreased in twenty-nine studies, increased in one study and remained stable in ten studies. Thirty-three studies analyzed the oral route for vitamin D administration, ten the intraperitoneal, one the subcutaneous and one the intravenous. A significant decrease of peritonitis risk was observed in two studies. Proteinuria decreased in four studies and remained stable in one study. Peritoneal protein loss decreased in one study and was stable in two studies. Studies on the therapeutic effects of vitamin D in PD are limited and describe small population samples. Moreover, vitamin D compounds do not consistently reduce PTH levels. The administration of active vitamin D in PD may have interesting pleiotropic effects such as decreasing proteinuria and peritoneal protein loss. According to these effects, vitamin D could help to preserve residual renal function and ensure efficient peritoneal membrane dialysance.
机译：维生素D缺乏症在透析中非常普遍，腹膜透析（PD）患者的胆钙化醇（25（OH）D-3）水平低于血液透析患者。我们进行了系统的叙述性回顾，以评估维生素D治疗对继发性甲状旁腺功能亢进症的控制以及维生素D多效性作用引起的临床结局。搜索Medline数据库以进行队列研究和干预研究，以报告有关维生素D（包括合成类似物在内的所有甾醇）和腹膜透析的数据，而无语言限制。两位作者独立提取数据。共确定了29项观察性研究和11项干预性研究（1,036名受试者）。 PTH水平在29项研究中下降，在一项研究中上升，在十项研究中保持稳定。 33项研究分析了口服维生素D的途径，其中10种是腹膜内的，一种是皮下的，一种是静脉内的。在两项研究中观察到腹膜炎风险显着降低。在四项研究中蛋白尿减少，在一项研究中保持稳定。一项研究中腹膜蛋白损失减少，两项研究稳定。关于PD中维生素D的治疗作用的研究有限，仅描述了少量人群。此外，维生素D化合物不能持续降低PTH水平。在PD中服用活性维生素D可能具有有趣的多效作用，例如减少蛋白尿和腹膜蛋白损失。根据这些作用，维生素D可以帮助保留残余的肾功能并确保有效的腹膜透析。

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