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高磷血症是尿毒症患者发生继发性甲旁亢和肾性骨病的主要原因。如能控制高磷血症,则可预防继发性甲旁亢的发生。磷通过调节肾脏1—羟化酶,从而使25(OH)D_3转化为1,25(OH)_2D_3。慢性肾衰患者磷的潴留是由于1—羟化酶的活性受到抑制,导致1,25(OH)_2D_3合成障碍,从而使肠道钙的吸收降低。晚近证实1,25(OH)_2D_3有调节甲状旁腺激素(PTH)的合成与分泌。为了控制慢性肾衰患者的血磷,常应用氢氧化铝。虽然能有效地预防严重的高磷血症及纤维囊性骨炎,然而可引起铝的积聚,可发生严重的骨病和脑病。
Hyperphosphatemia is the main cause of secondary hyperparathyroidism and renal osteodystrophy in patients with uremia. If you can control hyperphosphatemia, you can prevent the occurrence of secondary hyperparathyroidism. Phosphorus converts 25 (OH) D_3 to 1,25 (OH) _2D_3 by regulating renal 1-hydroxylase. Phosphorus retention in patients with chronic renal failure is due to the inhibition of 1-hydroxylase activity leading to a barrier of 1,25 (OH) _2D_3 synthesis, thereby reducing the intestinal absorption of calcium. Recently confirmed 1,25 (OH) _2D_3 regulation of parathyroid hormone (PTH) synthesis and secretion. In order to control the phosphorus in patients with chronic renal failure, aluminum hydroxide is often used. Although can effectively prevent severe hyperphosphatemia and fibrocystic osteitis, but can cause the accumulation of aluminum, can occur in severe bone disease and encephalopathy.