鈣化？鋁化？以上皆非？
張智鴻 、陳靖博
摘要
1970 年代腎臟病患者主要是靠含鋁磷結合劑治療高血磷症，在 1980 年後因為少數鋁中毒相關的病例，腎臟界者開始轉向含鈣磷結合劑治療。數十年後人們開始發現透析患者全身血管鈣化速度加快，因此又發展出了昂貴的非鈣非鋁磷結合劑。本文探討鋁和鈣對透析患者的影響，以及 2017 Kidney Disease Outcomes Quality Initiative（KDOQI）相關論述。
關鍵詞：慢性腎臟病、磷結合劑、血管鈣化
DOI：http://dx.doi.org/10.6340%2fKD.201809_30(3).0010
Calcification? Aluminization? None of Above?
Chih-Hung Chang, Jin-Bor Chen
Abstract
Patients with chronic kidney disease (CKD) commonly used aluminum-based salts as phosphate binder in 1970,and shifted to calcium-based phosphate binders because of several aluminum toxicity reports in 1980. Decades later,systemic vascular calcification of dialysis patients was noticed worldwide and thereafter new generations of non-calcium non-aluminum based phosphate binders were developed. This article discusses clinical effects of aluminum or calcium on dialysis patient and presents noteworthy sections of 2017 Kidney Disease Outcomes Quality Initiative (KDOQI).
Keywords: chronic kidney disease, phosphate binder, vascular calcification
2018年12月5日 星期三
2017年12月27日 星期三
副甲狀腺醫療發展簡史
副甲狀腺醫療發展簡史
A Brief Medical History of Parathyroids
張智鴻 (Chih-Hung Chang) ； 陳靖博 (Jin-Bor Chen)
腎臟與透析 ； 29卷2期 (2017 / 06 / 01) ， P93 - 96
繁體中文 DOI： 10.6340/KD.2017.29(2).10 DOI
副甲狀腺 ； 慢性腎臟病 ； 透析 ； 副甲狀腺機能亢進 ； parathyroid gland ； chronic kidney disease ； dialysis ； hyperparathyroidism
副甲狀腺是一個無聲的器官，在慢性腎臟病第三期就已經慢慢代償上升。臺灣尿毒症患者在透析9 年後，就有累積發生率12.5 % [1] 接受開刀切除它。本文簡介副甲狀腺醫療史的發展，經由20 世紀初這些勇敢創新的醫師，細心地抽絲剝繭這些當時令人困惑的病例，藉由病理和生理的檢查，逐漸找出病情的脈絡，也讓副甲狀腺醫療得以逐漸進步。
Parathyroid gland is a silent organ and has gradually becoming hyperfunction as compensation since chronic kidney disease stage 3. The uremic patients on dialysis in Taiwan has a cumulative incidence rate of 12.5% [1] to receive parathyroidectomy at the 9th year on renal replacement therapy. This essay briefly described medical history of parathyroid gland. With the braveness and innovativeness of doctors in the early 20th century, these puzzling medical problems become elucidating. This gland is understood more and more after detailed pathophysiological mechanism was explored.
http://www.airitilibrary.com/Publication/alDetailedMesh?docid=a0000067-201706-201709140001-201709140001-93-96
A Brief Medical History of Parathyroids
張智鴻 (Chih-Hung Chang) ； 陳靖博 (Jin-Bor Chen)
腎臟與透析 ； 29卷2期 (2017 / 06 / 01) ， P93 - 96
繁體中文 DOI： 10.6340/KD.2017.29(2).10 DOI
副甲狀腺 ； 慢性腎臟病 ； 透析 ； 副甲狀腺機能亢進 ； parathyroid gland ； chronic kidney disease ； dialysis ； hyperparathyroidism
副甲狀腺是一個無聲的器官，在慢性腎臟病第三期就已經慢慢代償上升。臺灣尿毒症患者在透析9 年後，就有累積發生率12.5 % [1] 接受開刀切除它。本文簡介副甲狀腺醫療史的發展，經由20 世紀初這些勇敢創新的醫師，細心地抽絲剝繭這些當時令人困惑的病例，藉由病理和生理的檢查，逐漸找出病情的脈絡，也讓副甲狀腺醫療得以逐漸進步。
Parathyroid gland is a silent organ and has gradually becoming hyperfunction as compensation since chronic kidney disease stage 3. The uremic patients on dialysis in Taiwan has a cumulative incidence rate of 12.5% [1] to receive parathyroidectomy at the 9th year on renal replacement therapy. This essay briefly described medical history of parathyroid gland. With the braveness and innovativeness of doctors in the early 20th century, these puzzling medical problems become elucidating. This gland is understood more and more after detailed pathophysiological mechanism was explored.
http://www.airitilibrary.com/Publication/alDetailedMesh?docid=a0000067-201706-201709140001-201709140001-93-96
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