PDF《尿酸与慢性肾脏病 - 矿物质和骨代谢异常的研究进展》

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chinagp.net E-mail:[email protected] 中国全科医学杂志 ・新进展・ 尿酸与慢性肾脏病 - 矿物质和骨代谢异常的研究进展 朱晓宇,姜丽丽,魏玉丹,张洋洋,黄秀,杜玉君 * 【摘要】 随着生活水平和饮食结构的改变,高尿酸血症的发病率呈不断上升趋势,流行病学调查显示,我国成 年人高尿酸血症的患病率为 8.4%~13.3%,高尿酸血症不仅是痛风的主要病因,而且是慢性肾脏病(CKD)进展和心血 管疾病死亡的独立危险因素,已经成为威胁人类健康的代谢性疾病之一.矿物质和骨代谢异常(MBD)是CKD 常见 的并发症,其包括矿物质代谢紊乱、骨骼病变和骨外钙化,可导致 CKD 患者住院率、心血管事件及死亡率增加.近 年研究发现尿酸与 CKD-MBD 之间可能密切相关,但其相关性目前仍存在争议,尚需深入研究论证.本文综述了尿酸 的病理生理功能、尿酸与 CKD-MBD 的关系及相互作用机制的研究进展. 【关键词】 尿酸;

慢性肾脏病;

矿物质和骨代谢异常 【中图分类号】 R 446.122 R

692 【文献标识码】 A DOI:10.12114/j.issn.1007-9572.2019.00.266 朱晓宇,姜丽丽,魏玉丹,等.尿酸与慢性肾脏病 - 矿物质和骨代谢异常的研究进展[J].中国全科医学, 2019.[Epub ahead of print].[www.chinagp.net] ZHU X Y,JIANG L L,WEI Y D,et al.Recent advances in uric acid and chronic kidney disease-mineral and bone disorder[J].Chinese General Practice,2019.[Epub ahead of print]. Recent Advances in Uric Acid and Chronic Kidney Disease-mineral and Bone Disorder ZHU Xiaoyu,JIANG Lili,WEI Yudan,ZHANG Yangyang,HUANG Xiu,DU Yujun* Department of Nephrology,the First Hospital of Jilin University,Changchun 130021,China * Corresponding author:DU Yujun,Chief physician,Doctoral supervisor;

E-mail:[email protected] 【Abstract】 With the changes in living standards and dietary structure,the incidence of hyperuricemia is on the rise. Epidemiological studies show that the prevalence of hyperuricemia in adults is 8.4% - 13.3% in China.A large number of studies have shown that hyperuricemia is not only the main cause of gout,but also an independent risk factor for the progression of chronic kidney disease(CKD) and cardiovascular death.It has become one of the metabolic diseases that threaten human health.Mineral and bone disorder are common complications of CKD,including mineral metabolism disorders,bone lesions and extra-osseous calcification,which can lead to increased hospitalization,cardiovascular events and mortality in patients with CKD.Recent studies have found uric acid may be closely related to CKD-mineral and bone disorder (CKD-MBD),but the correlation is still controversial and further researches are needed.This article reviews the pathophysiological function of uric acid,the relationship between uric acid and CKD-MBD and the recent advances of their interaction mechanism. 【Key words】 Uric acid;

Chronic kidney disease;

Mineral and bone disorder 要死亡原因,其致死风险远高于最终需要透析的风险,研究 表明 CVD 约占透析患者全因死亡率的 44.2%~51.0%[5] .血管 钙化被认为是心血管事件发病率和死亡率强有力的预测因素. 血管钙化的机制十分复杂,受多种因素的影响,矿物质和骨 代谢紊乱(MBD)是CKD 常见并发症,且是 CKD 患者动脉 粥样硬化和血管钙化发生、发展的主要贡献者,干预 CKD- MBD 发生、发展的危险因素可能成为减少 CKD 患者 CVD 发 生的关键点. 尿酸是嘌呤代谢的终产物,研究证实尿酸与血管钙化的 发生具有相关性,其不仅是痛风的主要病因,而且是 CKD 进 展和 CVD 患者死亡的独立危险因素[6] .随着生活水平及生 活方式的改变,高尿酸血症的患病率呈逐年增加且年轻化趋 势,尿酸已成为临床及科研工作者关注的热点.近年有研究