Phosphate and bone fracture risk in chronic kidney disease patients

被引：21

作者：

Fusaro, Maria ^{[1
,2
]}

Holden, Rachel ^{[3
]}

Lok, Charmaine ^{[4
]}

Iervasi, Giorgio ^{[1
]}

Plebani, Mario ^{[5
]}

Aghi, Andrea ^{[6
]}

Gallieni, Maurizio ^{[7
]}

Cozzolino, Mario ^{[8
,9
]}

机构：

[1] CNR, Inst Clin Physiol, Pisa, Italy

[2] Univ Padua, Dept Med, Padua, Italy

[3] Queens Univ, Dept Med, Div Nephrol, Kingston, ON, Canada

[4] Univ Toronto, Univ Hlth Network, Toronto Gen Hosp, Dept Med,Div Nephrol, Toronto, ON, Canada

[5] Univ Padua, Dept Med, Lab Med Unit, Padua, Italy

[6] Univ Padua, Dept Med, Clin Med 1, Padua, Italy

[7] Univ Milan, Dept Biomed & Clin Sci L Sacco, Nephrol & Dialysis Unit, ASST Fatebenefratelli Sacco, Milan, Italy

[8] Univ Milan, Dept Hlth Sci, ASST Santi Paolo & Carlo, Milan, Italy

[9] Renal Div, Milan, Italy

来源：

NEPHROLOGY DIALYSIS TRANSPLANTATION | 2021年 / 36卷 / 03期

关键词：

bone fractures; CKD; MBD; phosphate levels; DISORDER CKD-MBD; HEMODIALYSIS-PATIENTS; RENAL OSTEODYSTROPHY; DIETARY PHOSPHORUS; LANTHANUM CARBONATE; VERTEBRAL FRACTURES; DIALYSIS OUTCOMES; SERUM PHOSPHATE; TRANSPLANTATION; HOMEOSTASIS;

D O I：

10.1093/ndt/gfz196

中图分类号：

R3 [基础医学]; R4 [临床医学];

学科分类号：

1001 ; 1002 ; 100602 ;

摘要：

In chronic kidney disease (CKD), phosphate homoeostasis plays a central role in the development of mineral and bone disorder (MBD) together with decreased serum calcium and elevated serum parathyroid hormone, fibroblast growth factor 23 and sclerostin levels. Today there are only a few data exploring the direct role of abnormal phosphate homoeostasis and hyperphosphataemia in the development of CKD-MBD. On the other hand, several studies have looked at the link between hyperphosphataemia and cardiovascular morbidity and mortality in CKD, but there is a lack of evidence to indicate that lowering phosphate levels improves cardiovascular outcomes in this population. Furthermore, the impact of liberalizing phosphate targets on CKD-MBD progression and bone fracture is currently not known. In this review we discuss the central role of phosphate in the pathogenesis of CKD-MBD and how it may be associated with fracture risk, both in hyper- and hypophosphataemia.

引用

页码：405 / 412

页数：8