慢性肾脏病时矿物质代谢紊乱及骨代谢异常
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Increased UF
Peritoneal Membrane Transport
High
Time of Dialysis
24 Hr
Removal
of Phosphate
Dialysis Modality CAPD/CCPD
To convert serum calcium or albumin-corrected calcium (calcium Alb ) in mg/dL to mmol/L, multiply by 0.25.
To convert serum phosphorus in mg/dL to mmol/L, multiply by 0.323.
Managemห้องสมุดไป่ตู้nt of Hyperphosphatemia
Dietary phosphate restriction
Administration Removal of
of phosphate phosphate by
binder
dialysis and RRF
Bone and Teeth Hydroxyapatite
85%
Intracellular Fluid
Organic Phosphate
14%
Extracellular Fluid
Inorganic Phosphate
KDIGO Clinical Practice Guideline
慢性肾脏病 矿物质和骨异常 (CKD-MBD) 诊断评估预防和治疗
Aqueous
Aqueous
Aqueous
Middle Molecule
Removal of Phosphate
Residual Renal
Peritoneal Dialysis
Diffusive Clearance
Convective Clearance
Dialysate Glucose Concentration
<1%
Total-body phosphate
700 g
Dietary Phosphate
Efflux from Bone
Inorganic Phosphate
Protein Intake
60 – 64 g/d
Intake Phosphorus
6270 mg/wk
Intestinal Absorption
基础理论 K/DOQP K/DIGO
慢性肾脏病时的矿物质代谢紊乱及 骨代谢异常
长期的铝保留 因肾脏疾病或肾移植而使用糖皮质激素 既往甲状旁腺切除 维生素D治疗 糖尿病 ß 2微球蛋白性淀粉样变性 代谢性酸中毒 持续性饮食磷摄入限制或过度使用磷结合剂而导致的低磷血症
50%
Serum Phosphate 1.78 mmol/L
Total Weekly Phosphate Clearance
57 L/1.73 m2
Absorbed Phosphorus
3135 mg/wk
Aqueous
Aqueous
Aqueous
Aqueous Phosphate Aqueous
Peritoneal Membrane Transport
High
Time of Dialysis
24 Hr
Removal
of Phosphate
Dialysis Modality CAPD/CCPD
To convert serum calcium or albumin-corrected calcium (calcium Alb ) in mg/dL to mmol/L, multiply by 0.25.
To convert serum phosphorus in mg/dL to mmol/L, multiply by 0.323.
Managemห้องสมุดไป่ตู้nt of Hyperphosphatemia
Dietary phosphate restriction
Administration Removal of
of phosphate phosphate by
binder
dialysis and RRF
Bone and Teeth Hydroxyapatite
85%
Intracellular Fluid
Organic Phosphate
14%
Extracellular Fluid
Inorganic Phosphate
KDIGO Clinical Practice Guideline
慢性肾脏病 矿物质和骨异常 (CKD-MBD) 诊断评估预防和治疗
Aqueous
Aqueous
Aqueous
Middle Molecule
Removal of Phosphate
Residual Renal
Peritoneal Dialysis
Diffusive Clearance
Convective Clearance
Dialysate Glucose Concentration
<1%
Total-body phosphate
700 g
Dietary Phosphate
Efflux from Bone
Inorganic Phosphate
Protein Intake
60 – 64 g/d
Intake Phosphorus
6270 mg/wk
Intestinal Absorption
基础理论 K/DOQP K/DIGO
慢性肾脏病时的矿物质代谢紊乱及 骨代谢异常
长期的铝保留 因肾脏疾病或肾移植而使用糖皮质激素 既往甲状旁腺切除 维生素D治疗 糖尿病 ß 2微球蛋白性淀粉样变性 代谢性酸中毒 持续性饮食磷摄入限制或过度使用磷结合剂而导致的低磷血症
50%
Serum Phosphate 1.78 mmol/L
Total Weekly Phosphate Clearance
57 L/1.73 m2
Absorbed Phosphorus
3135 mg/wk
Aqueous
Aqueous
Aqueous
Aqueous Phosphate Aqueous