| 56 | 0 | 22 |
| 下载次数 | 被引频次 | 阅读次数 |
目的 分析血液透析患者维生素K代谢水平与慢性肾脏病-矿物质骨代谢紊乱(CKD-MBD)及钙、磷指标的相关性。方法 选取接受维持性血液透治疗患者150例，根据是否并发CKD-MBD分为CKD-MBD组和对照组，检测所有患者血清维生素K2、血清钙、血清磷及甲状旁腺激素(iPTH)等，分析维生素K2与钙、磷等指标的相关性及血液透析合并CKD-MBD的危险因素。结果 107例(71.33%)合并CKD-MBD。两组性别差异无统计学意义(P>0.05),但CKD-MBD组年龄及透析时间显著高于对照组(P<0.05);CKD-MBD组血清钙、磷、iPTH水平和钙磷乘积均高于对照组，维生素K2水平低于对照组，差异显著(P<0.05);Pearson相关性分析结果显示，维生素K2与血清钙、磷、iPTH及钙磷乘积均呈显著负相关(P<0.05);多因素Logistic回归分析结果显示，透析时间和维生素K2是血液透析合并CKD-MBD的独立影响因素(P<0.05)。结论 血液透析患者CKD-MBD风险较高，维生素K2代谢水平与其钙、磷等指标密切相关，是血液透析合并CKD-MBD的独立影响因素。
Abstract：1 Kalantar-Zadeh K,Jafar TH,Nitsch D,et al.Chronic kidney disease[J].Lancet,2021;398(10302):786-802.
2 Trinh E,Chan CT,Perl J.Dialysis modality and survival:done to death[J].Semin Dial,2018;31(4):315-24.
3 GBD Chronic Kidney Disease Collaboration.Global,regional,and national burden of chronic kidney disease,1990-2017:a systematic analysis for the Global Burden of Disease Study 2017[J].Lancet,2020;395(10225):709-33.
4 Zhu W,Lai Z,Xue M,et al.Elevated concentrations of cardiac troponin T are associated with thoracic aortic calcification in non-dialysis chronic kidney disease patients of stage G3 to G5[J].Ren Fail,2025;47(1):2440512.
5 陶婷婷，周慧，张圆圆，等.93例慢性肾脏病维持性血液透析患者血压异常发生调查、临床特点及影响因素[J].中华保健医学杂志，2024;26(6):857-9.
6 Chan W.Chronic kidney disease and nutrition support[J].Nutr Clin Pract,2021;36(2):312-30.
7 Brown EA,Zhao J,McCullough K,et al.Burden of kidney disease,health-related quality of life,and employment among patients receiving peritoneal dialysis and in-center hemodialysis:findings from the DOPPS program[J].Am J Kidney Dis,2021;78(4):489-500.
8 林蓉宇，陈巨星，曾东兰，等.碳酸司维拉姆治疗老年慢性肾脏病5期合并CKD-MBD的疗效[J].中国老年学杂志，2023;43(6):1351-4.
9 Kakani E,Elyamny M,Ayach T,et al.Pathogenesis and management of vascular calcification in CKD and dialysis patients[J].Semin Dial,2019;32(6):553-61.
10 Pazianas M,Miller PD.Osteoporosis and chronic kidney disease-mineral and bone disorder (CKD-MBD):back to basics[J].Am J Kidney Dis,2021;78(4):582-9.
11 Bulhões E,Antunes VLJ,Alexandre C,et al.Efficacy and safety of DOACs versus vitamin K antagonists in patients with atrial fibrillation and chronic kidney disease undergoing hemodialysis:a systematic review and meta-analysis of randomized controlled trials with trial sequential analysis[J].Heart rhythm,2025;22(5):1210-7.
12 Fusaro M,Gallieni M,Rizzo MA,et al.Vitamin K plasma levels determination in human health[J].Clin Chem Lab Med,2017;55(6):789-99.
13 Turner ME,Adams MA,Holden RM.The vitamin K metabolome in chronic kidney disease[J].Nutrients,2018;10(8):1076.
14 Halder M,Petsophonsakul P,Akbulut AC,et al.Vitamin K:double bonds beyond coagulation insights into differences between vitamin K1 and K2 in health and disease[J].Int J Mol Sci,2019;20(4):896.
15 Ketteler M,Leonard MB,Block GA,et al.KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis,evaluation,prevention,and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD)[J].Kidney Inter Suppl,2017;7(1):1-59.
16 Kaur R,Singh R.Mechanistic insights into CKD-MBD-related vascular calcification and its clinical implications[J].Life Sci,2022;311(Pt B):121148.
17 Kelly DM,Ademi Z,Doehner W,et al.Chronic kidney disease and cerebrovascular disease:consensus and guidance from a KDIGO controversies conference[J].Stroke,2021;52(7):e328-46.
18 徐婧，周鹏，刘永祥，等.骨疏康胶囊联合甲状旁腺切除治疗慢性肾脏病矿物质和骨代谢异常随机对照研究[J].中国中西医结合杂志，2025;45(2):176-82.
19 Yamada S,Nakano T.Role of chronic kidney disease (CKD)-mineral and bone disorder (MBD) in the pathogenesis of cardiovascular disease in CKD[J].J Atheroscler Thromb,2023;30(8):835-50.
20 Salera D,Merkel N,Bellasi A,et al.Pathophysiology of chronic kidney disease-mineral bone disorder (CKD-MBD):from adaptive to maladaptive mineral homeostasis[J].Clin Kidney J,2025;18(1):ii3-i14.
21 Cahalane Rachel M,Barrett Hilary E,Ross Aisling M,et al.On the association between circulating biomarkers and atherosclerotic calcification in a cohort of arterial disease participants[J].Nutr Metabol Cardiovasc Dis,2021;31(5):1533-41.
22 李月，刘艳，路更，等.维生素K对CKD-MBD骨代谢异常以及血管钙化的治疗及作用机制[J].中国骨质疏松杂志，2022;28(2):308-12.
23 Elenjickal EJ,Travlos CK,Marques P,et al.Anticoagulation in patients with chronic kidney disease[J].Am J Nephrol,2024;55(2):146-64.
24 Rodriguez Mejia R,Singh A,Bahekar A,et al.Direct oral anticoagulants versus vitamin K antagonists in chronic kidney disease patients undergoing transcatheter aortic valve replacement:a systematic review and meta-analysis[J].Cureus,2025;17(2):e79052.
25 Geng C,Huang L,Pu L,et al.Effects of vitamin K supplementation on vascular calcification in chronic kidney disease:a systematic review and meta-analysis of randomized controlled trials[J].Front Nutr,2023;9:1001826.
26 Kaesler N,Schurgers LJ,Floege J.Vitamin K and cardiovascular complications in chronic kidney disease patients[J].Kidney Int,2021;100(5):1023-36.
27 郭姗姗.维持性血液透析患者矿物质代谢不达标状况及其危险因素分析[J].四川生理科学杂志，2025;47(2):291-4.
28 Sprague SM,Martin KJ,Coyne DW.Phosphate balance and CKD-mineral bone disease[J].Kidney Int Rep,2021;6(8):2049-58.
29 彭科军，余三峰，彭濡博，等.老年骨质疏松患者骨代谢指标与维生素D和维生素K水平的相关性[J].中国临床保健杂志，2022;25(4):496-9.
基本信息:
中图分类号:R692.5
引用信息:
[1]马爽,王磊,王林华,等.血液透析患者维生素K代谢水平与CKD-MBD及钙、磷指标的相关性[J].中国老年学杂志,2026,46(09):1605-1608.
基金信息:
吉林省自然科学基金项目(YDZJ202301ZYTS200); 吉林省杰出青年基金项目(20240101007JJ)
2026-05-08
2026-05-08