臨牀透析 Vol.31 No.6(2-1)


特集名 骨関節障害・CKD-MBDの概念を再考する
題名 治療介入の意義 (1) CKD-MBD診療のマーカーとoutcome
発刊年月 2015年 06月
著者 横山 啓太郎 東京慈恵会医科大学腎臓・高血圧内科
【 要旨 】 慢性腎臓病(CKD)における骨・ミネラル代謝の異常は,長期的には血管を含む全身の石灰化を介して,生命予後にも影響を及ぼす病態として,全身性疾患として「慢性腎臓病に伴う骨・ミネラル代謝異常(CKD-mineral and bone disorder;CKD-MBD)」という概念でとらえられるようになった.わが国では2006年と2012年にガイドラインが発表されたが,これらのガイドラインは生命予後をoutcomeとして策定されている.本稿では,CKD-MBDガイドラインのoutcomeと診療マーカーの臨床的意義について概説する.
Theme Testify the concepts of renal osteodystrophy and chronic kidney disease-bone and mineral disorder (CKD-MBD)
Title Clinical significance of outcomes and CKD-MBD practice markers
Author Keitaro Yokoyama Division of Kidney and Hypertension, Department of Internal Medicine, Jikei University School of Medicine
[ Summary ] The term 'renal osteodystrophy' has recently been replaced by 'chronic kidney disease-mineral and bone disorder (CKD-MBD)', which includes abnormalities in bone and mineral metabolism, as well as vascular calcification. The Japanese Society for Dialysis Therapy's clinical practice guidelines for management of secondary hyperparathyroidism in chronic dialysis patients were originally published in Japanese in 2006. The guidelines were revised to include a number of new policies. A new guideline was published in Japanese in 2012. These guidelines were established to address outcomes concerned with mortality in CKD patients. This article outlines the clinical significance of outcomes and practice markers in relation to the CKD-MBD guidelines.
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