引用本文:张慧玲,谢忠建.慢性肾脏病患者应重视补充普通维生素D[J].中国临床新医学,2018,11(12):1192-1195.
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慢性肾脏病患者应重视补充普通维生素D
张慧玲,谢忠建
410011 长沙,中南大学湘雅二医院代谢内分泌科,代谢性骨病学湖南省重点实验室,国家代谢性疾病临床医学研究中心(张慧玲,谢忠建);414000 湖南,岳阳市一人民医院内分泌科(张慧玲)
摘要:
[摘要] 慢性肾脏病(chronic kidney disease,CKD)患者常伴有营养性维生素D缺乏的情况,虽然活性维生素D已被广泛用于CKD的治疗,但普通维生素D的补充尚未得到足够关注。研究证实普通维生素D的补充区别于活性维生素D临床意义,充足的25(OH)D水平除了能给肾脏尚存的1α羟化酶提供足够的底物以外,还可促进肾外组织在局部产生更多的1,25(OH)2D,调节许多组织细胞的增殖和分化。因此,对CKD患者来说,除了补充活性维生素D外,普通维生素D的补充也值得重视。
关键词:  慢性肾脏病  维生素D缺乏  普通维生素D  活性维生素D
DOI:10.3969/j.issn.1674-3806.2018.12.04
分类号:R 692
基金项目:国家自然科学基金项目(编号:81072219,81272973,81471055,81672646)
Nutritional vitamin D supplementation requires attention to patients with chronic kidney disease
ZHANG Hui-ling, XIE Zhong-jian
Department of Endocrinology and Metabolism, Hunan Provincial Key Laboratory of Metabolic Bone Diseases, National Clinical Research Center for Metabolic Disease, the Second Xiangya Hospital of Central South University, Changsha 410011, China
Abstract:
[Abstract] Patients with chronic kidney disease(CKD) are more prone to developing vitamin D deficiency. Although traditional therapies with active vitamin D or vitamin D analogues have been widely used in patients with CKD, nutritional vitamin D supplementation is not paid much attention. There is increasing evidence suggesting that supplementation with plain vitamin D has important clinical benefits distinguishing from active vitamin D. Adequate serum 25(OH)D not only provides renal 1 alpha hydroxylase with sufficient substrate, but also contributes to local production of 1, 25(OH)2D in the extra-renal tissues. Thus generating their own 1, 25(OH)2D from circulating 25(OH)D creates pleiotropic effects, including regulation of proliferation and differentiation of many cell types. Therefore, nutritional vitamin D supplementation should be paid sufficient attention in CKD patients with vitamin D deficiency.
Key words:  Chronic kidney disease(CKD)  Vitamin D deficiency  Nutritional vitamin D  Active vitamin D