臨床検査62巻6号

2018年06月発行

今月の特集1 The Bone—骨疾患の病態と臨床検査

CKD（chronic kidney disease）とMBD（mineral bone disorder）

著者： 中川洋佑¹ 深川雅史¹

所属機関： ¹東海大学医学部腎内分泌代謝内科

ページ範囲：P.718 - P.722

Point

●慢性腎臓病（CKD）早期から骨・ミネラル代謝異常（MBD）の病態は進展している．

●CKD-MBDは全身疾患であり，血管石灰化の進展に伴って生命予後に深く影響を与える．

●血清リン，カルシウム，副甲状腺ホルモン（PTH），アルカリホスファターゼ（ALP）などを定期的に測定し，治療介入に結び付けることが肝要である．

参考文献

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4）Danese MD, Kim J, Doan QV, et al：PTH and the risks for hip, vertebral, and pelvic fractures among patients on dialysis. Am J Kidney Dis　47：149-156，2006

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7）日本透析医学会：慢性腎臓病に伴う骨・ミネラル代謝異常の診療ガイドライン．透析会誌　45：301-356，2012

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12）Palmer SC, Hayen A, Macaskill P, et al：Serum levels of phosphorus, parathyroid hormone, and calcium and risks of death and cardiovascular disease in individuals with chronic kidney disease: a systematic review and meta-analysis. JAMA　305：1119-1127，2011

13）Hill KM, Martin BR, Wastney ME, et al：Oral calcium carbonate affects calcium but not phosphorus balance in stage 3-4 chronic kidney disease. Kidney Int　83：959-966，2013

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