中国血液净化

中国血液净化 ›› 2022, Vol. 21 ›› Issue (12): 903-906,916.doi: 10.3969/j.issn.1671-4091.2022.12.009

• 综述 • 上一篇    下一篇

肾性骨营养不良诊断进展

谢 胜   欧阳春   

  1. 213300 溧阳, 1江苏省人民医院溧阳分院溧阳市人民医院肾内科
    210029 南京, 2南京医科大学第一附属医院江苏省人民医院肾内科
  • 收稿日期:2022-05-17 修回日期:2022-09-13 出版日期:2022-12-12 发布日期:2022-12-12
  • 通讯作者: 欧阳春 E-mail:oyc@njmu.edu.cn

Recent advances in the diagnosis of renal osteodystrophy

XIE Sheng, OUYANG Chun   

  1. Department of Nephrology, Liyang People’s Hospital, Liyang Branch of Jiangsu Provincial Hospital, Liyang 213300, China; 2Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Provincial Hospital, Nanjing 210029, China
  • Received:2022-05-17 Revised:2022-09-13 Online:2022-12-12 Published:2022-12-12
  • Contact: 213300 溧阳, 1江苏省人民医院溧阳分院溧阳市人民医院肾内科 210029 南京, 2南京医科大学第一附属医院江苏省人民医院肾内科 E-mail:oyc@njmu.edu.cn

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摘要： 肾性骨营养不良(renal osteodystrophy，ROD)指慢性肾脏病-矿物质和骨异常(chronic kidney disease-mineral and bone disorder，CKD-MBD)的骨改变。尽管四环素标记的经髂骨活检是ROD诊断和分型的金标准，但受有创性、患者意愿和专家等的限制，在临床上几乎不开展。本文综述了近年来ROD的诊断新进展，包括骨活检的改良，无创成像技术的兴起，新型骨转换标志物(bone turnover marker，BTM)的出现及相互间的组合应用，使得无创精准的“虚拟骨活检”成为可能。

关键词: 肾性骨营养不良, 骨活检, 骨转换标志物, 成像技术

Abstract: Renal osteodystrophy (ROD) refers to the skeletal alterations of chronic kidney disease-mineral and bone disorder (CKD-MBD) in patients with chronic kidney disease (CKD). Tetracycline-labeled bone biopsy is a golden standard for the diagnosis and classification of ROD. However, bone biopsy is often rejected by the patients and professionals due to the invasive operation. This review focuses on recent advances in the diagnosis of ROD, including modified bone biopsy, non-invasive imaging techniques, and novel bone turnover markers, enabling to develop a non-invasive and accurate virtual bone biopsy that improves diagnostic performance.

Key words: Renal osteodystrophy, Bone biopsy, Bone turnover marker, Imaging technique

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