慢性肾脏病继发性甲状旁腺功能亢进的发病机制研究进展

继发性甲状旁腺功能亢进是慢性肾脏病的常见并发症,严重影响患者的生活质量和生存率。其发病机制主要包括低钙血症、高磷血症、活性维生素D缺乏、维生素D受体及钙敏感受体表达下调等。近年来,成纤维细胞生长因子23在继发性甲状旁腺功能亢进发病机制中的作用,也越来越受到重视。上述机制均可导致慢性肾脏病患者的甲状旁腺细胞增生,由多克隆增生逐渐发展为单克隆增生、腺瘤等,甲状旁腺功能亢进也逐渐加重。现就慢性肾脏病继发性甲状旁腺功能亢进的发病机制的进展做一综述。

Progress of Pathogenesis of Secondary Hyperparathyroidismin Chronic Kidney Disease

Secondary hyperparathyroidism(SHPT) is the common complication in chronic kidney disease which seriously affects the patient''s quality of life and decrease the survival rates. The pathogenesis of this disease includes: hypocalcemia, hyperphosphatemia, the decreased levels of active vitamin D, vitamin D receptor and calcium-sensing receptor. Recently, the elevated level of fibroblast growth factor 23 is also subjected to the value more and more. The above factors can induce parathyroid hyperplasia from polyclone, monoclone, even adenoma, and SHTP may becomemore and more serious. In this review, the progress of pathogenesis in secondary hyperparathyroidismin chronic kidney disease will be introduced.