腎と骨代謝 Vol.16 No.4(1)


特集名 血管と骨代謝の接点
題名 [本特集のねらい]腎不全と「骨-血管相関」
発刊年月 2003年 10月
著者 重松 隆 東京慈恵会医科大学附属青戸病院腎臓・高血圧内科
【 要旨 】 生物が海から陸上に移動し発達した臓器が腎臓と骨である.このため,腎不全となると骨代謝回転は円滑に行われず腎性骨症が惹起され,骨からカルシウム(Ca) やリンが遊離したり,骨のCaやリン取り込み能力が低下する.臨床上は異所性石灰化として捉えられ,とくに血管の石灰化が問題となる.こうした関係は「腎不全と骨不全」という軸から「骨-血管相関」という関係が推測される.最近になり,血管の石灰化機構は,単に余剰のCaが沈着するという単純な図式ではなく,その進展機構は骨組織における骨形成と石灰化に共通する部分が多いことも判明してきた.そこで今回,本特集では血管と骨代謝の関係に焦点を当て編集してみた.
Theme The impact of bone and Ca/Pi metabolism on vascular disease
Title The impact of bone and Ca/Pi metabolism on vascular disease
Author Takashi Shigematsu Division of Nephrology and Hypertension, Department of Internal Medicine, Aoto-General Hospital, Jikei University School of Medicine
[ Summary ] The skeletal system and kidneys have developed in response to the transition from a sea based life to a land based life. A result of this change is a great number of renal failures resulting in the renal osteodystrophy. Bone metabolism related to turnover is not good in renal failure patients. Calcium and phosphorus are released from bone tissue because of failures in the calcium/phosphorus buffering system. Cardiovascular disease is a major problem in renal patients, with calcification of the atherosclerotic vessels being one of a conspicuous features. I would like to propose two concepts: "The renal failure and skeletal failure AXIS" and "The correlation between Bone and Vessels". Recently, the mechanism for vascular calcification has been thought to be quite similar to that for bone formation with calcification. Therefore, I chose, "The relationship between blood vessels and bone" as the main thesis of this issue.
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