摘要
慢性肾脏病(CKD)患者随着肾功能减退,贫血的发生率也逐渐上升,这不仅严重影响患者生活质量,还增加心血管风险,降低患者生存率。肾性贫血发病机制复杂,目前普遍认为促红细胞生成素(EPO)产生不足、EPO抵抗、微炎症状态、铁代谢紊乱、缺氧诱导因子氧传感途径异常及继发性甲状旁腺功能亢进等因素参与其发生发展。维生素D缺乏与肾性贫血发病机制关系密切,CKD患者血清维生素D水平与血红蛋白水平呈正相关,且补充活性维生素D可有效改善肾性贫血、减轻EPO抵抗及微炎症状态,但具体机制尚不明确。
With the decline of renal function in patients with chronic kidney disease(CKD),the incidence of anemia gradually increases,which not only seriously affects the quality of life of the patients,but also increases the cardiovascular risk and reduces the survival rate of the patients.The pathogenesis of renal anemia is complex,and it is generally believed that the deficiency of erythropoietin(EPO)production,EPO resistance,microinflammatory state,iron metabolism disorder,abnormal oxygen sensing pathway of hypoxia-inducible factor and secondary hyperparathyroidism are involved in its occurrence and development.Vitamin D deficiency is closely related to the pathogenesis of renal anemia.Serum vitamin D level in patients with CKD is positively correlated with hemoglobin level,and active vitamin D supplementation can effectively improve renal anemia,reduce EPO resistance and microinflammation,although the specific mechanism remains unclear.
作者
王雷
彭红英
WANG Lei;PENG Hongying(Department of Nephrology,Affiliated Hospital of Guizhou Medical University,Guiyang 550004,China;Department of Nephrology,Baiyun Hospital Affiliated to Guizhou Medical University,Guiyang 550025,China)
出处
《医学综述》
CAS
2022年第20期4059-4064,共6页
Medical Recapitulate
基金
贵州省卫生健康委科学技术基金项目(gzwjkj2020-1-080)
贵阳市科技计划项目(筑科合同〔2018〕1-73号)。
