Intestinal Phosphorus Absorption in Chronic Kidney Disease.
Intestinal Phosphorus Absorption in Chronic Kidney Disease.
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DOI：
10.3390/nu10101364
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发表时间：
2018-09-23
期刊：
影响因子：
5.9
通讯作者：
Hill Gallant KM
中科院分区：
文献类型：
--
作者：
Stremke ER;Hill Gallant KM
慢性肾脏病（CKD）影响全球约10%的成年人。CKD中发生的磷稳态失调导致CKD-矿物质骨障碍（CKD-MBD）的发展，并导致这些患者的发病率和死亡率增加。磷受多种激素（甲状旁腺激素（PTH）、1，25-二羟基维生素D（1，25 D）和成纤维细胞生长因子23（FGF 23））和组织（肾、肠、甲状旁腺和骨）调节，以维持体内平衡。在健康状况下，肾脏是调节磷稳态的主要场所。然而，随着肾功能下降，肾脏充分排泄磷的能力降低。CKD患者的激素变化表明，肠道应通过减少肠道磷吸收分数来补偿肾磷排泄受损。然而，在CKD动物模型和CKD患者中的有限研究表明，在肠道无法补偿的情况下，这种稳态反应可能会中断。由于CKD中许多现有的磷酸盐管理疗法旨在减少肠磷的绝对吸收，因此更好地了解影响分数和绝对吸收的因素，肠磷吸收发生的机制以及CKD如何改变这些是急需的研究领域。
Chronic kidney disease (CKD) affects approximately 10% of adults worldwide. Dysregulation of phosphorus homeostasis which occurs in CKD leads to development of CKD-Mineral Bone Disorder (CKD-MBD) and contributes to increased morbidity and mortality in these patients. Phosphorus is regulated by multiple hormones (parathyroid hormone (PTH), 1,25-dihyxdroxyvitamin D (1,25D), and fibroblast growth factor 23 (FGF23)) and tissues (kidney, intestine, parathyroid glands, and bone) to maintain homeostasis. In health, the kidneys are the major site of regulation for phosphorus homeostasis. However, as kidney function declines, the ability of the kidneys to adequately excrete phosphorus is reduced. The hormonal changes that occur with CKD would suggest that the intestine should compensate for impaired renal phosphorus excretion by reducing fractional intestinal phosphorus absorption. However, limited studies in CKD animal models and patients with CKD suggest that there may be a break in this homeostatic response where the intestine fails to compensate. As many existing therapies for phosphate management in CKD are aimed at reducing absolute intestinal phosphorus absorption, better understanding of the factors that influence fractional and absolute absorption, the mechanism by which intestinal phosphate absorption occurs, and how CKD modifies these is a much-needed area of study.
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影响因子：
6.2
作者：
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通讯作者：
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DOI：
10.1056/nejmoa0706130
发表时间：
2008-08-07
期刊：
The New England journal of medicine
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作者：
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