中国血液净化

中国血液净化 ›› 2017, Vol. 16 ›› Issue (04): 220-223.doi: 10.3969/j.issn.1671-4091.2017.04.002

• 专题 • 上一篇    下一篇

腹膜透析与维生素D的研究进展

刘海洋1,刘虹1   

  1. 1. 中南大学湘雅二医院肾内科中南大学湘雅二医院血液净化中心中南大学(湘雅二医院) 肾脏病研究所肾脏疾病与血液净化学湖南省重点实验室
  • 收稿日期:2016-12-27 修回日期:2016-11-30 出版日期:2017-04-12 发布日期:2017-04-12
  • 通讯作者: 刘虹 liuh0618@163.com E-mail:liuh0618@163.com
  • 基金资助:

    中国仁泽基金会2016 全国专项基金维生素D对透析患者贫血作用前瞻性临床研究

The research progress of vitamin D and peritoneal dialysis

  • Received:2016-12-27 Revised:2016-11-30 Online:2017-04-12 Published:2017-04-12

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摘要： 随着全世界范围内慢性肾脏病透析患者的人数的不断增加，如何提高透析患者生活质量成为重要课题。腹膜透析患者因为饮食限制、食欲下降、户外活动量受到限制，致维生素D 的摄入减少及合成受阻，数据显示血清25(OH)D 水平＜50ng/ml 的腹膜透析患者的比例可高达97%。腹膜透析患者维生素D 水平与慢性肾脏病矿物质及骨代谢紊乱(chronic kidney disease–mineral and bone disorder, CKD-MBD)的进展、心血管事件、认知功能、肌肉力量等都具有联系。研究证明，腹膜透析患者补充维生素D 可通过刺激巨噬细胞、调节免疫功能等减少腹透相关性腹膜炎、起到抗腹膜纤维化作用等。而补充维生素D 及其相关制品应需防止高钙血症的发生，定期检测血钙、血磷、全段甲状旁腺激素(intact parathyroid hormone,iPTH)值。本文就腹膜透析患者维生素D 水平、维生素D 对腹膜透析患者的作用以及治疗等进行综述。

关键词: 慢性肾脏病, 维生素D, 腹膜透析

Abstract: With the increasing number of chronic kidney disease patients worldwidely, how to improve the quality of life of these patients becomes an important issue. Vitamin D intake and synthesis of 25(OH) vitamin D are reduced because of the less diet intake and outdoor activities in peritoneal dialysis (PD) patients. Previous data showed that serum 25(OH) vitamin D level less than 50ng/ml was found in 97% PD patients. Serum vitamin D level is related to chronic kidney disease - mineral and bone disorder (CKD-MBD), cardiovascular events, cognitive function, muscle strength, etc. Supplement of vitamin D can prevent PD-related peritonitis and peritoneal fibrosis through the stimulation of macrophages and regulation of immune functions. Serum calcium, phosphorus and iPTH should be monitored regularly to prevent hypercalcemia during the supplement of vitamin D and its related preparations. This review focuses on vitamin D level in PD patients and the effects of vitamin D preparations on PD patients.

Key words: Chronic kidney disease, Vitamin D, Peritoneal dialysis