Calciphylaxis in CKD and beyond
Calciphylaxis in CKD and beyond
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DOI：
10.1093/ndt/gfs015
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发表时间：
2012-04-01
影响因子：
6.1
通讯作者：
Ketteler, Markus
中科院分区：
文献类型：
--
作者：
Brandenburg, Vincent M.;Kramann, Rafael;Ketteler, Markus
钙过敏症仍然是一种不完全了解的罕见疾病，最常影响血液透析患者。对于大多数患者来说，钙过敏症意味着生活质量的大幅下降，并与高发病率和死亡率相关。我们仍然对最终导致钙过敏症的局部和全身危险因素以及潜在原因知之甚少。最近来自亚洲的研究指出，在肾脏病的诊断和管理方面存在持续的不确定性，肾脏病学界必须通过建立诊断和治疗策略的标准来解决这一问题。Hayashi等人发表了一项日本调查的结果，其中作者收集了钙化耐受患者的数据，并将临床和实验室数据与对照受试者的数据进行了比较。这种创新的方法使作者能够计算出各种参数的相对风险，在钙化预防发展方面。虽然不受控制的甲状旁腺功能亢进似乎起次要作用，但维生素K拮抗剂的使用被证明特别重要。调查和登记数据可能有助于缩小我们对钙过敏的认识上的差距，这可能最终导致预防、患者护理和结局的改善。
Calciphylaxis is still an incompletely understood rare disease, which most often affects people on haemodialysis. For the majority of patients, calciphylaxis means a massive reduction in quality of life and is associated with high morbidity and mortality. We still know little about the concert of local and systemic risk factors and underlying causes that finally lead to the development of calciphylaxis. Recent work from Asia points towards persistent uncertainties in the diagnosis and management of the disease which the nephrology community has to address by establishing standards in both diagnosis as well as treatment strategies. Hayashi et al. have published results from a Japanese survey in which the authors collected data from calciphylaxis patients and compared clinical and laboratory data with those of control subjects. This innovative approach allowed the authors to calculate relative risks for various parameters in terms of calciphylaxis development. While uncontrolled hyperparathyroidism seemingly plays a secondary role, vitamin K antagonist usage proved to be of particular importance. Survey as well as registry data may help to close the gap in our knowledge about calciphylaxis which may ultimately result in improved prevention, patient care and outcome.