慢性肾脏病矿物质骨代谢异常课件

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,慢性肾脏病中的钙化问题,David A Bushinsky, MD,医学药攣学,生学 John j. Kuiper杰出授,罗斯防特大学医学院,胃病科主任,罗切筋特木学医学中心,罗切斯特市纽约W,美国,慢性肾脏病中的钙化问题,1,Disclosure Statement,The content and clinical recommendations with the best evidence available from,all sources which I am involved will promote quality or improvements in healthcare,and will not promote a specific proprietary business interest of a commercial,interest in nature,I will uphold academic standards to ensure balance, independence, objectivity, and,scientific rigor in my role in the planning, development, or presentation of this CME,tivity, including any presentation of therapeutic options. The content will be,well-balanced, evidence-based, unbiased,I will inform learners when i discuss or reference investigational or off-label use of,therapeutic agents or product.,Disclosure Statement,2,eGRR与死亡率和心血管事件发生率的相关性,14.1,6045-5930-44,eGFR (mL/min/1.73,20295例成年受试者,年龄标准化发生率/100病人年;心血管事件定义为:因冠心病住院、心衰、缺血性卒中和外周动脉,Go AS, et al. N EnglJ Med, 2019, 351: 1296-1305,eGRR与死亡率和心血管事件发生率的相关性,3,eGRR与死亡率和心血管事件发生率的相关性,世缺目,6045-59304415-2915,6045-5930-4415-2985,年龄,Foley RN, et al. Am /Kidney Dls, 2019: 32(suppl 3) 5112-5119,透析患者的心血管疾病死亡率更高,5,透析患者的死亡原因,Causes of death in dialysis patients,a Cardiac arrest/arrhythmia,a Othe,国 Stroke, Nonvascular causes,27%,Figure 71.1 Causes of death in dialysis patients. CVD,cardiovascular disease, M, myocardial infarction. (Data from,USRDS, 2019),Sevier items and derived items 2019 by Mosby, Inc. an affiliate of Elsevier Inc,透析患者的死亡原因,6,慢性肾脏病的危险因素,Cardiovascular,Wasing,re 71. 4 Risk facto,ehensive dlin Neph 2019,慢性肾脏病的危险因素,7,慢性肾脏病的危险因素,Cardiovascular,Wasing,re 71. 4 Risk facto,ehensive dlin Neph 2019,慢性肾脏病的危险因素,8,CKD-MBD的病理生理学,CKD-MBD的病理生理学,9,磷代谢平衡,成人体内含磷总量700g,85%在,食物,1200mg/日,骨形成,骨吸收,300mg/日,300mg/日,吸收,血液1%,950mg/日,磷库,1350mg/日,排泄,150mg/日,粪便排泄,尿磷排泄,400mg/日,日,磷代谢平衡,10,慢性肾脏病矿物质骨代谢异常课件,11,慢性肾脏病矿物质骨代谢异常课件,12,慢性肾脏病矿物质骨代谢异常课件,13,慢性肾脏病矿物质骨代谢异常课件,14,慢性肾脏病矿物质骨代谢异常课件,15,慢性肾脏病矿物质骨代谢异常课件,16,慢性肾脏病矿物质骨代谢异常课件,17,慢性肾脏病矿物质骨代谢异常课件,18,慢性肾脏病矿物质骨代谢异常课件,19,慢性肾脏病矿物质骨代谢异常课件,20,慢性肾脏病矿物质骨代谢异常课件,21,慢性肾脏病矿物质骨代谢异常课件,22,慢性肾脏病矿物质骨代谢异常课件,23,慢性肾脏病矿物质骨代谢异常课件,24,慢性肾脏病矿物质骨代谢异常课件,25,慢性肾脏病矿物质骨代谢异常课件,26,慢性肾脏病矿物质骨代谢异常课件,27,慢性肾脏病矿物质骨代谢异常课件,28,慢性肾脏病矿物质骨代谢异常课件,29,慢性肾脏病矿物质骨代谢异常课件,30,慢性肾脏病矿物质骨代谢异常课件,31,慢性肾脏病矿物质骨代谢异常课件,32,慢性肾脏病矿物质骨代谢异常课件,33,慢性肾脏病矿物质骨代谢异常课件,34,慢性肾脏病矿物质骨代谢异常课件,35,慢性肾脏病矿物质骨代谢异常课件,36,慢性肾脏病矿物质骨代谢异常课件,37,慢性肾脏病矿物质骨代谢异常课件,38,慢性肾脏病矿物质骨代谢异常课件,39,慢性肾脏病矿物质骨代谢异常课件,40,慢性肾脏病矿物质骨代谢异常课件,41,慢性肾脏病矿物质骨代谢异常课件,42,慢性肾脏病矿物质骨代谢异常课件,43,慢性肾脏病矿物质骨代谢异常课件,44,慢性肾脏病矿物质骨代谢异常课件,45,慢性肾脏病矿物质骨代谢异常课件,46,慢性肾脏病矿物质骨代谢异常课件,47,慢性肾脏病矿物质骨代谢异常课件,48,慢性肾脏病矿物质骨代谢异常课件,49,慢性肾脏病矿物质骨代谢异常课件,50,慢性肾脏病矿物质骨代谢异常课件,51,慢性肾脏病矿物质骨代谢异常课件,52,慢性肾脏病矿物质骨代谢异常课件,53,慢性肾脏病矿物质骨代谢异常课件,54,慢性肾脏病矿物质骨代谢异常课件,55,