慢性肾脏疾病继发性甲状旁腺功能亢进:病理机制和目前治疗的可能性。

Małgorzata Rodzoń-Norwicz, Sebastian Norwicz, Magdalena Sowa-Kućma, Agnieszka Gala-Błądzińska
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引用次数: 0

摘要

继发性甲状旁腺功能亢进(SHPT)是由慢性肾脏疾病(CKD)引起的最常见的代谢并发症之一。肾脏疾病改善全球结果(KDIGO)工作组将与CKD相关的钙和磷酸盐疾病的复杂性定义为CKD相关矿物质和骨骼疾病(CKD-MBD)。KDIGO关于CKD-MBD行为准则的最后一次更新发布于2017年。SHPT的治疗基于两种策略:对抗高磷血症和抑制甲状旁腺激素(PTH)分泌。治疗应以最佳选择的药物为基础,考虑到额外的效果,以降低慢性并发症和副作用的风险。新药的开发具有更好的安全性、显著减少副作用、更有效地实现目标血清磷和PTH值,这迫使人们逐渐用新的药物疗法取代现有的治疗方法。本研究的目的是讨论有关继发性甲状旁腺功能亢进的病理机制的最新问题(与最新的KDIGO指南有关)以及这些疾病的当前治疗方向。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Secondary hyperparathyroidism in chronic kidney disease: pathomechanism and current treatment possibilities.

Secondary hyperparathyroidism (SHPT) is one of the most common metabolic complications resulting from chronic kidney disease (CKD). The complexity of calcium and phosphate disorders associated with CKD is defined by the Kidney Disease Improvement Global Outcomes (KDIGO) working group as CKD-related mineral and bone disorders (CKD-MBD). The last update of the KDIGO guidelines on the conduct in CKD-MBD was published in 2017. The treatment of SHPT is based on 2 strategies: counteracting hyperphosphataemia and suppressing parathyroid hormone (PTH) secretion. Therapy should be based on optimally selected drugs, taking into account additional effects to reduce the risk of chronic complications and side effects. The creation of new drugs with a better safety profile, significant reduction of side effects, and greater efficiency in achieving target serum phosphorus and PTH values forces the gradual replacement of existing treatment with new pharmacotherapies. The aim of this study is to discuss the latest issues (in connection with the latest KDIGO guidelines) regarding the pathomechanism of secondary hyperparathyroidism and the current directions of the therapy in these disorders.

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