Mineral and bone abnormalities after renal transplantation
-
摘要: 慢性肾脏病-矿物质和骨异常(CKD-MBD)是由于慢性肾脏病导致的矿物质及骨代谢异常综合征。由于肾移植受者(KTR)移植前已普遍存在矿物质和骨异常(MBD),移植后残存MBD加之移植肾功能和免疫抑制剂等的影响,几乎所有KTR都会面临不同程度甚至更为复杂的MBD临床问题。本文主要针对肾移植术后常见的MBD,包括高钙血症、低钙血症、高磷血症、低磷血症、继发性甲状旁腺功能亢进、维生素D缺乏、骨质疏松症、骨坏死、血管钙化进行阐述。
-
[1] VANGALA C, PAN J, COTTON RT, et al. Mineral and bone disorders after kidney transplantation[J]. Front Med (Lausanne), 2018, 5:211. DOI: 10.3389/fmed.2018.00211. [2] AMIN T, COATES PT, BARBARA J, et al. Prevalence of hypercalcaemia in a renal transplant population: a single centre study[J]. Int J Nephrol, 2016:7126290. DOI: 10.1155/2016/7126290. [3] WOLF M, WEIR MR, KOPYT N, et al. A prospective cohort study of mineral metabolism after kidney transplantation[J]. Transplantation, 2016, 100(1):184-193. DOI: 10.1097/TP.0000000000000823. [4] SAVAJ S, GHODS FJ. Vitamin D, parathyroid hormone, and bone mineral density status in kidney transplant recipients[J]. Iran J Kidney Dis, 2012, 6(4):295-299. [5] EGBUNA OI, TAYLOR JG, BUSHINSKY DA, et al. Elevated calcium phosphate product after renal transplantation is a risk factor for graft failure[J]. Clin Transplant, 2007, 21(4):558-566. doi: 10.1111/j.1399-0012.2007.00690.x [6] RAMEZANI M, EINOLLAHI B, ASL MA, et al. Calcium and phosphorus metabolism disturbances after renal transplantation[J]. Transplant Proc, 2007, 39(4):1033-1035. doi: 10.1016/j.transproceed.2007.03.025 [7] KIM YJ, KIM MG, JEON HJ, et al. Clinical manifestations of hypercalcemia and hypophosphatemia after kidney transplantation[J]. Transplant Proc, 2012, 44(3):651-656. DOI: 10.1016/j.transproceed.2011.12.050. [8] GWINNER W, SUPPA S, MENGEL M, et al. Early calcification of renal allografts detected by protocol biopsies: causes and clinical implications[J]. Am J Transplant, 2005, 5(8):1934-1941. doi: 10.1111/j.1600-6143.2005.00938.x [9] ALSHAYEB HM, JOSEPHSON MA, SPRAGUE SM. CKD-mineral and bone disorder management in kidney transplant recipients[J]. Am J Kidney Dis, 2013, 61(2):310-325. DOI: 10.1053/j.ajkd.2012.07.022. [10] BARROS X, FUSTER D, PASCHOALIN R, et al. Changes in bone mineral metabolism parameters, including FGF23, after discontinuing cinacalcet at kidney transplantation[J]. Endocrine, 2015, 49(1):267-273. DOI: 10.1007/s12020-014-0400-1. [11] EVENEPOEL P, COOPER K, HOLDAAS H, et al. A randomized study evaluating cinacalcet to treat hypercalcemia in renal transplant recipients with persistent hyperparathyroidism[J]. Am J Transplant, 2014, 14(11):2545-2555. DOI: 10.1111/ajt.12911. [12] SPRAGUE SM, BELOZEROFF V, DANESE MD, et al. Abnormal bone and mineral metabolism in kidney transplant patients--a review[J]. Am J Nephrol, 2008, 28(2):246-253. doi: 10.1159/000110875 [13] BAIA LC, HEILBERG IP, NAVIS G, et al. Phosphate and FGF-23 homeostasis after kidney transplantation[J]. Nat Rev Nephrol, 2015, 11(11):656-666. DOI: 10.1038/nrneph.2015.153. [14] VAN LONDEN M, AARTS BM, DEETMAN PE, et al. Post-transplant hypophosphatemia and the risk of death-censored graft failure and mortality after kidney transplantation[J]. Clin J Am Soc Nephrol, 2017, 12(8):1301-1310. DOI: 10.2215/CJN.10270916. [15] JEON HJ, KIM YC, PARK S, et al. Association of serum phosphorus concentration with mortality and graft failure among kidney transplant recipients[J]. Clin J Am Soc Nephrol, 2017, 12(4):653-662. DOI: 10.2215/CJN.07090716. [16] TATARANNI T, BIONDI G, CARIELLO M, et al. Rapamycin-induced hypophosphatemia and insulin resistance are associated with mTORC2 activation and Klotho expression[J]. Am J Transplant, 2011, 11(8):1656-1664. DOI: 10.1111/j.1600-6143.2011.03590.x. [17] TOMIDA K, HAMANO T, ICHIMARU N, et al. Dialysis vintage and parathyroid hormone level, not fibroblast growth factor-23, determines chronic-phase phosphate wasting after renal transplantation[J]. Bone, 2012, 51(4):729-736. DOI: 10.1016/j.bone.2012.06.027. [18] LOU I, FOLEY D, ODORICO SK, et al. How well does renal transplantation cure hyperparathyroidism?[J]. Ann Surg, 2015, 262(4):653-659. DOI: 10.1097/SLA.0000000000001431. [19] MOLNAR MZ, KOVESDY CP, MUCSI I, et al. Association of pre-kidney transplant markers of mineral and bone disorder with post-transplant outcomes[J]. Clin J Am Soc Nephrol, 2012, 7(11):1859-1871. DOI: 10.2215/CJN.01910212. [20] KOVÁCS DÁ, FEDOR R, ASZTALOS L, et al. Surgical treatment of hyperparathyroidism after kidney transplant[J]. Transplant Proc, 2019, 51(4):1244-1247. DOI: 10.1016/j.transproceed.2019.03.008. [21] HEAF J, TVEDEGAARD E, KANSTRUP IL, et al. Hyperparathyroidism and long-term bone loss after renal transplantation[J]. Clin Transplant, 2003, 17(3):268-274. doi: 10.1034/j.1399-0012.2003.00047.x [22] RODRIGUEZ M, NEMETH E, MARTIN D. The calcium-sensing receptor: a key factor in the pathogenesis of secondary hyperparathyroidism[J]. Am J Physiol Renal Physiol, 2005, 288(2):F253-F264. doi: 10.1152/ajprenal.00302.2004 [23] TABIBZADEH N, CHAVAROT N, FLAMANT M, et al. Biphosphonate therapy, risk of fracture, and sites of bone mineral density assessments in kidney transplantation[J]. J Am Soc Nephrol, 2019, 30(5):905. DOI: 10.1681/ASN.2019010079. [24] BOUQUEGNEAU A, SALAM S, DELANAYE P, et al. Bone disease after kidney transplantation[J]. Clin J Am Soc Nephrol, 2016, 11(7):1282-1296. DOI: 10.2215/CJN.11371015. [25] KOCH NOGUEIRA PC, DAVID L, COCHAT P. Evolution of secondary hyperparathyroidism after renal transplantation[J]. Pediatr Nephrol, 2000, 14(4):342-346. doi: 10.1007/s004670050772 [26] TIOSANO D, HOCHBERG Z. Hypophosphatemia: the common denominator of all rickets[J]. J Bone Miner Metab, 2009, 27(4):392-401. DOI: 10.1007/s00774-009-0079-1. [27] VAUTOUR LM, MELTON LJ 3RD, CLARKE BL, et al. Long-term fracture risk following renal transplantation: a population-based study[J]. Osteoporos Int, 2004, 15(2):160-167. doi: 10.1007/s00198-003-1532-y [28] 王泰娜, 徐斌, 贾凤玉, 等.帕立骨化醇治疗血液透析患者伴继发性甲状旁腺功能亢进[J].肾脏病与透析肾移植杂志, 2015, 24(1):1-5. http://d.old.wanfangdata.com.cn/Periodical/szbytxsyzzz201501001WANG TN, XU B, JIA FY, et al. Treatment of secondary hyperparathyroidism in hemodilysis patients by paricalcitol[J]. Chin J Nephrol Dial Transplant, 2015, 24(1):1-5. http://d.old.wanfangdata.com.cn/Periodical/szbytxsyzzz201501001 [29] SZWARC I, ARGILÉS A, GARRIGUE V, et al. Cinacalcet chloride is efficient and safe in renal transplant recipients with posttransplant hyperparathyroidism[J]. Transplantation, 2006, 82(5):675-680. doi: 10.1097/01.tp.0000232452.80018.ad [30] Erratum: Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD update work group. KDIGO 2017 clinical practice guideline update for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD)[J]. Kidney Int Suppl, 2017, 7(3):1-59. DOI: 10.1016/j.kisu.2017.10.001. [31] CUNNINGHAM J, LOCATELLI F, RODRIGUEZ M. Secondary hyperparathyroidism: pathogenesis, disease progression, and therapeutic options[J]. Clin J Am Soc Nephrol, 2011, 6(4):913-921. DOI: 10.2215/CJN.06040710. [32] RAGGI P, CHERTOW GM, TORRES PU, et al. The advance study: a randomized study to evaluate the effects of cinacalcet plus low-dose vitamin D on vascular calcification in patients on hemodialysis[J]. Nephrol Dial Transplant, 2011, 26(4):1327-1339. DOI: 10.1093/ndt/gfq725. [33] FALCK P, VETHE NT, ASBERG A, et al. Cinacalcet' s effect on the pharmacokinetics of tacrolimus, cyclosporine and mycophenolate in renal transplant recipients[J]. Nephrol Dial Transplant, 2008, 23(3):1048-1053. [34] LORENZ K, BARTSCH DK, SANCHO JJ, et al. Surgical management of secondary hyperparathyroidism in chronic kidney disease--a consensus report of the European Society of Endocrine Surgeons[J]. Langenbecks Arch Surg, 2015, 400(8):907-927. DOI: 10.1007/s00423-015-1344-5. [35] 国家肾脏疾病临床医学研究中心.中国慢性肾脏病矿物质和骨异常诊治指南概要[J].肾脏病与透析肾移植杂志, 2019, 28(1):52-57. DOI:10.3969/j.issn.1006-298X. 2019.01.012.National Clinical Research Center For Kidney Disease. Summary of guidelines for the diagnosis and treatment of mineral and bone abnormalities in chronic kidney disease in China[J]. Chin J Nephrol Dial Transplant, 2019, 28(1):52-57.DOI: 10.3969/j.issn.1006-298X.2019.01.012. [36] 罗丽花, 管保章, 黄盛玲, 等.微波消融治疗继发性甲状旁腺功能亢进2例的短期疗效观察[J].中华肾脏病杂志, 2015, 31(4):312-313.DOI: 10.3760/cma.j.issn.1001-7097.2015.04.016.LUO LH, GUAN BZ, HUANG SL, et al. The short-term effect of microwave ablation on 2 cases of secondary hyperparathyroidism[J]. Chin J Nephrol, 2015, 31(4):312-313.DOI: 10.3760/cma.j.issn.1001-7097.2015.04.016. [37] HOLICK MF. Vitamin D deficiency[J]. N Engl J Med, 2007, 357(3):266-281. doi: 10.1056/NEJMra070553 [38] RIZVI SM, VEIERØD MB, THORSBY PM, et al. Vitamin D in Norwegian renal transplant recipients: a longitudinal study with repeated measurements in winter and summer[J]. Eur J Dermatol, 2015, 25(3):234-239. DOI: 10.1684/ejd.2015.2524. [39] BIENAIMÉ F, GIRARD D, ANGLICHEAU D, et al. Vitamin D status and outcomes after renal transplantation[J]. J Am Soc Nephrol, 2013, 24(5):831-841. DOI: 10.1681/ASN.2012060614. [40] KEYZER CA, RIPHAGEN IJ, JOOSTEN MM, et al. Associations of 25(OH) and 1, 25(OH)2 vitamin D with long-term outcomes in stable renal transplant recipients[J]. J Clin Endocrinol Metab, 2015, 100(1):81-89. DOI: 10.1210/jc.2014-3012. [41] LE FUR A, FOURNIER MC, GILLAIZEAU F, et al. Vitamin D deficiency is an independent risk factor for PTDM after kidney transplantation[J]. Transpl Int, 2016, 29(2):207-215. DOI: 10.1111/tri.12697. [42] ASTOR BC, DJAMALI A, MANDELBROT DA, et al. The association of 25-hydroxyvitamin D levels with late cytomegalovirus infection in kidney transplant recipients: the Wisconsin Allograft Recipient Database[J]. Transplantation, 2019, 103(8):1683-1688. DOI: 10.1097/TP.0000000000002672. [43] SÁNCHEZ FRUCTUOSO AI, MAESTRO ML, CALVO N, et al. Role of fibroblast growth factor 23 (FGF23) in the metabolism of phosphorus and calcium immediately after kidney transplantation[J]. Transplant Proc, 2012, 44(9):2551-2554. DOI: 10.1016/j.transproceed.2012.09.070. [44] SAITO H, MAEDA A, OHTOMO S, et al. Circulating FGF-23 is regulated by 1alpha, 25-dihydroxyvitamin D3 and phosphorus in vivo[J]. J Biol Chem, 2005, 280(4):2543-2549. doi: 10.1074/jbc.M408903200 [45] BACIC D, LEHIR M, BIBER J, et al. The renal Na+/phosphate cotransporter NaPi-Ⅱa is internalized via the receptor-mediated endocytic route in response to parathyroid hormone[J]. Kidney Int, 2006, 69(3):495-503. doi: 10.1038/sj.ki.5000148 [46] BRANDENBURG VM, KETTELER M, FASSBENDER WJ, et al. Development of lumbar bone mineral density in the late course after kidney transplantation[J]. Am J Kidney Dis, 2002, 40(5):1066-1074. doi: 10.1053/ajkd.2002.36345 [47] NIKKEL LE, HOLLENBEAK CS, FOX EJ, et al. Risk of fractures after renal transplantation in the United States[J]. Transplantation, 2009, 87(12):1846-1851. DOI: 10.1097/TP.0b013e3181a6bbda. [48] VAN STAA TP. The pathogenesis, epidemiology and management of glucocorticoid-induced osteoporosis[J]. Calcif Tissue Int, 2006, 79(3):129-137. doi: 10.1007/s00223-006-0019-1 [49] CANALIS E, MAZZIOTTI G, GIUSTINA A, et al. Glucocorticoid-induced osteoporosis: pathophysiology and therapy[J]. Osteoporos Int, 2007, 18(10):1319-1328. doi: 10.1007/s00198-007-0394-0 [50] CUETO-MANZANO AM, KONEL S, CROWLEY V, et al. Bone histopathology and densitometry comparison between cyclosporine a monotherapy and prednisolone plus azathioprine dual immunosuppression in renal transplant patients[J]. Transplantation, 2003, 75(12):2053-2058. doi: 10.1097/01.TP.0000068869.21770.F6 [51] MARTÍN-FERNÁNDEZ M, RUBERT M, MONTERO M, et al. Effects of cyclosporine, tacrolimus, and rapamycin on osteoblasts[J]. Transplant Proc, 2017, 49(9):2219-2224. DOI: 10.1016/j.transproceed.2017.07.005. [52] SAKAGUCHI Y, HAMANO T, WADA A, et al. Magnesium and risk of hip fracture among patients undergoing hemodialysis[J]. J Am Soc Nephrol, 2018, 29(3):991-999. DOI: 10.1681/ASN.2017080849. [53] REINHARDT W, KÜBBER H, DOLFF S, et al. Rapid recovery of hypogonadism in male patients with end stage renal disease after renal transplantation[J]. Endocrine, 2018, 60(1):159-166. DOI: 10.1007/s12020-018-1543-2. [54] LENIHAN CR, SUKUMARAN NAIR S, VANGALA C, et al. Proton pump inhibitor use and risk of hip fracture in kidney transplant recipients[J]. Am J Kidney Dis, 2017, 69(5):595-601. DOI: 10.1053/j.ajkd.2016.09.019. [55] 中华医学会骨质疏松和骨矿盐疾病分会.原发性骨质疏松症诊疗指南(2017)[J].中国骨质疏松杂志, 2019, 25(3):281-309.DOI: 10.3969/j.issn.1006-7108.2019.03.001.Branch of Osteoporosis and Bone Mineral Salt Disease of Chinese Medical Association. Guidelines for the diagnosis and management of primary osteoporosis (2017)[J]. Chin J Osteoporos, 2019, 25(3):281-309. DOI: 10.3969/j.issn.1006-7108.2019.03.001. [56] 中华医学会骨质疏松和骨矿盐疾病分会.骨代谢生化标志物临床应用指南[J].中华骨质疏松和骨矿盐疾病杂志, 2015, 8(4):283-293.DOI: 10.3969/j.issn.1674-2591.2015.04.001.Branch of Osteoporosis and Bone Mineral Salt Disease of Chinese Medical Association. Clinical application guidelines for biochemical markers of bone metabolism[J]. Chin J Osteoporos Bone Mine Res, 2015, 8(4):283-293. DOI: 10.3969/j.issn.1674-2591.2015.04.001. [57] KOH LK, SEDRINE WB, TORRALBA TP, et al. A simple tool to identify asian women at increased risk of osteoporosis[J]. Osteoporos Int, 2001, 12(8):699-705. doi: 10.1007/s001980170070 [58] WHO. Assessment of osteoporosis at the primary health care level[EB/OL]. (2015-12-08).http://www.who.int/chp/topics/Osteoporosis.pdf. [59] SEAMON J, KELLER T, SALEH J, et al. The pathogenesis of nontraumatic osteonecrosis[J]. Arthritis, 2012:601763. DOI: 10.1155/2012/601763. [60] KERACHIAN MA, SÉGUIN C, HARVEY EJ. Glucocorticoids in osteonecrosis of the femoral head: a new understanding of the mechanisms of action[J]. J Steroid Biochem Mol Biol, 2009, 114(3/4/5):121-128. DOI: 10.1016/j.jsbmb.2009.02.007. [61] 李子荣.股骨头坏死临床诊疗规范[J].中华骨与关节外科杂志, 2015, 387(1):1-6.DOI: 10.3969/j.issn.2095-9958.2015.01-001.LI ZR. Clinical diagnosis and treatment specification of femoral head necrosis[J]. Chin J Bone Joint Surg, 2015, 387(1):1-6. DOI: 10.3969/j.issn.2095-9958.2015.01-001. [62] OJO AO, MORALES JM, GONZÁLEZ-MOLINA M, et al. Comparison of the long-term outcomes of kidney transplantation: USA versus Spain[J]. Nephrol Dial Transplant, 2013, 28(1):213-220. DOI: 10.1093/ndt/gfs287. [63] THOMPSON B, TOWLER DA. Arterial calcification and bone physiology: role of the bone-vascular axis[J]. Nat Rev Endocrinol, 2012, 8(9):529-543. DOI: 10.1038/nrendo.2012.36. [64] RAGGI P, GIACHELLI C, BELLASI A. Interaction of vascular and bone disease in patients with normal renal function and patients undergoing dialysis[J]. Nat Clin Pract Cardiovasc Med, 2007, 4(1):26-33. doi: 10.1038/ncpcardio0725
点击查看大图
计量
- 文章访问数: 226
- HTML全文浏览量: 143
- PDF下载量: 27
- 被引次数: 0