摘要
背景:肾移植患者经常患有与矿物骨病(CKD-MBD)相关的慢性肾病,这是一种主要影响肾移植患者的复杂疾病。移植后骨病很复杂,特别是在已有代谢性骨病的患者中,这些疾病进一步受到免疫抑制药物和肾同种异体移植功能变化的影响。肾移植 (KTx) 中矿物质代谢的主要生化异常包括低磷血症、甲状旁腺功能亢进 (HPTH)、维生素 D 不足或缺乏以及高钙血症。 目的:总结KTx中CKD-MBD的病理生理学及主要生物标志物。 方法:在PubMed中独立进行全面、非系统的检索,强调KTx矿质骨病中的生物标志物 结果:CKD-MBD可能与许多因素有关,包括继发性HPTH,KTx之前的代谢失调以及移植后受试者的糖皮质激素治疗。成纤维细胞生长因子23(FGF23)在KTx后达到正常水平,具有良好的同种异体移植功能,而钙,维生素D和磷最终分别导致高钙血症,持续性维生素D不足和低磷血症。至于PTH水平,最初有显着下降的趋势,随后由于二级或三级HPTH而升高。关于硬化素水平,文献中没有共识 结论:应持续评估KTx患者的矿物质稳态和骨状态,包括肾移植成功和功能降低的患者。对 CKD-MBD 病理生理学、诊断和管理的额外研究对于保证 KTx 患者的长期移植物功能、更好的预后、良好的生活质量和降低死亡率至关重要。
关键词: 骨矿物质病,肾移植,慢性肾病,维生素D,钙,磷酸盐,甲状旁腺功能亢进,成纤维细胞生长因子23。
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