关键词: 慢性肾脏病 , 活性维生素D , 营养性维生素D

Abstract:

The serum levels of 25-hydroxyvitamin D insufficiency or deficiency remains common in most individuals with end-stage renal disease (ESRD). However, it is still argued that which kind of vitamin D analogues-active vitamin D or nutritional vitamin D, is used for treatment. Kidney Disease Outcome Quality Initiative (K/DOQI) guideline suggests that nutritional vitamin D(NVD) is initiated to treat nondialysis chronic kidney disease (CKD) patients with secondary hyperparathyroidism for low levels of 25-hydroxyvitamin D (<30ng/ml).Though some small sample studies, which exist significant defects on design or implementation of clinical trials, showed that nutritional vitamin D can decrease levels of parathyroid hormone, and improve sensitivity to erythropoietin stimulating agents and glycemic, nutritional vitamin D is not proved to improve survival. In contrast, active vitamin D can exert significant survival advantage on reducing mortality of CKD patients and increased biochemical marker-alkaline phosphatase, with coronary artery calcification.

Key words: chronic kidney disease , active vitamin D , nutritional vitamin D