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Hyperphosphatemia

内分泌

关键词内分泌 疾病 电解质紊乱

词汇介绍

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解析

Hyperphosphatemia   英 /:haipəfɔsfə'ti:mjə/

释    义   n. [医] 血磷酸盐过多;[医] 高磷酸盐血

例    句   Objective: To investigate the clinical characteristics and mechanism of renal failure due to acute hyperphosphatemia following intravenous fructose diphosphate injection. 目的:探讨注射用二磷酸果糖致急性高磷血症的临床特点及诱发急性肾功能衰竭的发病机理。

概述

高磷血症是一种电解质紊乱,血液中有水平升高的磷酸盐,大多数人没有症状,而一些人则在软组织中形成钙沉积。通常,钙含量也很低,但是可能导致肌肉痉挛。原因包括肾衰竭,甲状旁腺功能减退症,糖尿病酮症酸中毒,肿瘤溶解综合征,和横纹肌溶解等。原因大多数人每天从红肉,奶制品,鸡肉,鱼和强化谷物等食物中获取约800至1200 mg的磷。在人体中,磷酸盐在骨骼和牙齿,细胞内部以及在血液中的含量要少得多。肾脏有助于去除体内多余的磷酸盐,以保持体内的平衡。当肾脏受损时,身体无法足够快地从血液中去除磷酸盐,这会导致

Effect of Intradialytic Exercise on Hyperphosphatemia and Malnutrition复制标题

透析锻炼对高磷血症和营养不良的影响

发表时间:2019-10-15

影响因子:4.2

作者: Nada Salhab

期刊:Nutrients

Hyperphosphatemia, described as the “silent killer” for hemodialysis (HD) patients, is prevalent among almost half of this population and is a determinant to decreased quality of life (QOL). The Kidney Disease Improving Global Outcomes (KDIGO) guidelines (2017) recommend lowering the serum phosphorus (P) levels towards the range that is considered normal for healthy populations. Standard HD regimes of 4-h three times a week cannot remove the entire P load; thus, other serum P controlling interventions are used such as limiting dietary P intake and administration of P-binding medications. However, these techniques provide some risks: the P-restricted diet can lead to protein energy malnutrition, and P-binders can cause gastrointestinal side effects, which may increase the cost of health care. This is a specific concern because there is no conclusive evidence about P-binder cost-effectiveness as first-line intervention for hyperphosphatemia management. All of which raises the need for adjunct novel effective approaches targeting hyperphosphatemia management, such as intradialytic exercise (IDE). Recently, 2 meta-analyses showed that exercise does not appear to have a significant impact on serum P compared to controls; however, most of the studies included in these reviews were relatively short term. IDE has been the focus of many researchers for the last two decades. Orcy et al. (2014) reported an increase in P clearance with IDE among HD patients. Also, other studies showed a decrease in serum P levels with IDE. It is hypothesized that exercise increases blood flow and decreases inter-compartmental resistance leading to increased toxin removal through the dialyzer. Moreover, IDE potentially has a positive effect on patient’s QOL, dialysis adequacy (Kt/V), urea reduction ratio (URR), C-reactive protein (CRP) levels, and functional capacity. Finally, in HD patients, body composition is significantly associated with physical functioning and QOL; thus, any attempt targeting muscle and fat distribution should be encouraged.

译文

高磷酸盐血症被描述为血液透析(HD)患者的“沉默杀手”,在该人群的近一半中普遍存在,并且是生活质量下降(QOL)的决定因素。肾脏疾病改善全球结局(KDIGO)指南(2017)建议将血清磷(P)水平降低至健康人群认为正常的范围。每周3次,每次4小时的标准高清模式无法消除整个P负载;因此,可以使用其他控制血清P的干预措施,例如限制饮食中P的摄入量和P结合药物的给药。但是,这些技术存在一些风险:限制P的饮食会导致蛋白质能量营养不良,而P粘合剂会引起胃肠道副作用,这可能会增加医疗保健成本。这是一个特别令人担忧的问题,因为尚无确凿的证据表明作为高磷血症管理的一线干预措施,P结合剂的成本效益。所有这些都导致需要针对高磷血症管理的辅助新颖有效方法,例如透析内运动(IDE)。最近,有2项荟萃分析显示,与对照组相比,锻炼似乎对血清P的影响不显着。但是,这些评价中包括的大多数研究都是相对短期的。在过去的二十年中,IDE一直是许多研究人员关注的焦点。 Orcy等。 (2014年)报道了HD患者中IDE的P清除率增加。另外,其他研究表明IDE可使血清P水平降低。据推测,运动会增加血液流动并降低房间阻力,从而导致通过透析器去除毒素的增加。此外,IDE可能会对患者的生活质量,透析充分性(Kt / V),尿素减少率(URR),C反应蛋白(CRP)水平和功能能力产生积极影响。最后,在HD患者中,身体成分与身体机能和生活质量显着相关。因此,应鼓励任何针对肌肉和脂肪分布的尝试。