ISSN 1006-298X      CN 32-1425/R

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肾脏病与透析肾移植杂志 ›› 2017, Vol. 26 ›› Issue (1): 85-89.DOI: 10.3969/cndt.j.issn.1006-298X.2017.01.019

• 论文 • 上一篇    下一篇

肾移植术后的高钙血症

  

  • 出版日期:2017-02-28 发布日期:2017-02-21

Hypercalcemia after renal transplantation

  • Online:2017-02-28 Published:2017-02-21

摘要:

随着肾功能的减退,慢性肾脏病(CKD)患者不仅出现血钙、血磷水平变化和继发性甲状旁腺功能亢进,还将引发骨代谢异常和血管及软组织钙化,称为慢性肾脏病矿物质和骨异常(CKDMBD)。肾移植术后,大部分受者CKDMBD的症状得到极大改善,但部分受者会出现高钙血症。高钙血症发生率的报道差异很大。肾移植术后1年内高钙血症发生率为15%~30%,1年后发生率为5%~10%。影响因素包括术前透析时间和术后持续的甲状旁腺功能亢进等。随着肾功能的恢复,部分受者术后早期的高钙血症可自行缓解。持续严重的高钙血症可能加重异位钙化,增加肾脏损害、心血管疾病及死亡风险,故需要积极寻找原因,并予治疗和纠正,这对提高肾移植受者的生活质量和远期预后具有重要意义。

Abstract:

As kidney function declines, there is a progressive deterioration in mineral and bone homeostasis in chronic kidney disease (CKD), with abnormal concentrations of calcium, phosphorus, PTH, or vitamin D metabolism, abnormal bone and extraskeletal calcification. The clinical syndrome is defined as CKDmineral and bone disorder (CKDMBD). Kidney transplantation improves CKDMBD greatly, but hypercalcemia is common in kidney transplant recipients. The studies report wide variation of prevalence. The prevalence of hypercalcemia is 15%~30% and 5%~10% within 1 year and 1 year after renal transplantation. The important causes for hypercalcemia are pretransplantation duration on dialysis and persistent posttransplant hyperparathyroidism. The spontaneous resolution of hypercalcemia may happen in the early posttransplant period. Chronic severe hypercalcemia may exacerbate heterotopic calcification, resulting in higher risks of the kidney injury, cardiovascular diseases and death. So, finding out the causes and therapeutic interventions is important for recipients to improve quality of life and longterm outcomes.