腎と骨代謝 Vol.20 No.2(1)


特集名 CKD-MBDに関するエビデンスとガイドライン
題名 CKD-MBDの新しい概念
発刊年月 2007年 04月
著者 濱田 康弘 神戸大学医学部附属病院代謝機能疾患治療部,腎臓内科
著者 深川 雅史 神戸大学医学部附属病院代謝機能疾患治療部,腎臓内科
【 要旨 】 骨ミネラル代謝異常は慢性腎臓病 (CKD) においてごく一般的にみられ,この合併症を総称して腎性骨異栄養症 (ROD) と呼んでいるが,これはCKD患者に伴う骨ミネラル代謝異常を十分に表現できているとはいいがたい.そこで,2005年9月にKDIGOよりCKD患者に伴うカルシウム,リン,副甲状腺ホルモン,ビタミンD代謝の異常,骨回転,石灰化,骨量,骨強度の異常,血管,軟部組織の異所性石灰化といったものを包括した概念として「chronic kldney disease-mineral and bone disorder (CKD-MBD) : 慢性腎臓病に伴う骨ミネラル代謝異常」という用語が提唱された.
Theme Evidence-based clinical guidelines for CKD-MBD in Japan
Title CKD-MBD : new concept concerning bone and mineral disorders in patients with CKD
Author Yasuhiro Hamada Divison of Nephrology and Dialysis Center, Kobe University Graduate School of Medicine
Author Masafumi Fukagawa Divison of Nephrology and Dialysis Center, Kobe University Graduate School of Medicine
[ Summary ] Disturbances in mineral metabolism, as well as bone disorders, are common complications of chronic kidney disease (CKD) and an important causes of morbidity and decreased quality of life. These disturbances have traditionally been termed ‘renal osteodystrophy’ and classified, based on bone biopsy information. However, the traditional definition of renal osteodystrophy does not completely describe the disorders in patients with CKD. Therefore, the second Kidney Disease : Improving Global Outcomes (KDIGO) Controversies Conference on ‘Definition, Evaluation, and Classification of Renal Osteodystrophy’ was held on September 15-17, 2005 in Madrid, Spain. In this conference, it was recommended that the term ‘renal osteodystrophy’ should be used exclusively to define the bone pathology associated with CKD. It was also determined that the term ‘CKD-Mineral and Bone Disorder (CKD-MBD)’ should be used to describe a broader clinical syndrome that develops as a systemic disorder, related to mineral and bone metabolism due to CKD. CKD-MBD is manifested by abnormalities in bone and mineral metabolism including laboratory abnormalities, bone disease and/or extra skeletal calcification.
戻る