终末期肾病焦磷酸盐代谢与骨矿代谢紊乱相关性的研究
摘要
焦磷酸盐(PPi)可抑制羟磷灰石的形成,并显示对VD中毒鼠的血管钙化有抑制作用。近期研究发现内源性的PPi可预防用高浓度钙磷培养液培养的鼠大动脉的钙化。为了解终末期肾病(ESRD)以及血液透析患者PPi代谢的状况,本试验检测了上述患者血清PPi浓度以及与之代谢相关的酶,即核苷焦磷酸水解酶和碱性磷酸酶的活性,并对PPi的代谢与ESRD和血透患者的钙磷代谢紊乱的相关性进行了分析。38例血液透析患者和28例尿毒症患者以及22例正常对照者的血清PPi水平分别为1.99±0.14μmmol/ml、2.08±0.23μmmol/ml、和2.00±0.17μmmol/ml;与对照者比较,尿毒症患者的血清PPi水平高于血液透析患者和正常对照者,(P < 0.05,P < 0.05)后两者之间无差异显著性(P > 0.05);血液透析、尿毒症患者以及正常对照者的血清NTPPPH活性分别为23.84±4.18U/ml、21.61±5.18U/ml和20.34±5.24 U/ml ,与对照组比较P值分别为P <0.01和P>0.05;碱性磷酸酶活性在血液透析患者最高,尿毒症患者次之,与正常对照者比较分别为P <0.05和P < 0.05,但尿毒症患者和血液透析患者之间无显著差异。血清NTPPPH活性与PPi浓度之间呈显著负相关(r=-0.35),而与P和Ca×P之间呈正相关(r=0.30、r=0.31)。结果显示,尿毒症患者的血清PPi水平高于血液透析患者和正常对照者,其可能与透析有关。依据NTPPPH活性与PPi的负性相关性和与血清P及Ca×P正性相关性结果,推测NTPPPH可能与ALP协同作用促进异位钙化的形成。
Pyrophosphate (PPi) is a known inhibitor of hydroxyapatite formation and has been shown to inhibit medial vascular calcification in vitamin D–toxic rats. It was demonstrated recently that endogenous production of PPi prevents calcification of rat aorta that are cultured in high concentrations of calcium and phosphate. To determining whether PPi metabolism is altered in ESRD and hemodialysis patients, plasma levels PPi and its relative metabolic enzymes, namely nucleotide pyrophosphohydrolase(NTPPPH) and alkaline phosphatase(ALP) were measured in the ESRD and stable hemodialysis patients. And the relationship between the metabolism of PPi and the disorders of bone and mineral were analyzed. The serum [PPi] was 1.99±0.14μmmol/ml in 38 clinically stable hemodialysis patients and 2.08±0.23μmmol/ml in 28 uremia patients compared with 2.00±0.17μmmol/ml in 22 normal subjects (P > 0.05, P < 0.05, respectively). The serum NTPPPH activity was 23.84±4.18 U/ml in 38 clinically stable hemodialysis patients and 21.61±5.18 U/ml in 28 uremia patients compared with 20.34±5.24 U/ml in 22 normal subjects (P <0.01, P > 0.05, respectively). The ALP was highest in hemodialysis patients, uremia patients took second place compared with normal subjects. (P <0.05, P < 0.05, respectively). There was a inverse correlation between PPi level and NTPPPH.(r=-0.35)A positive relationship was observed between NTPPPH activity and serum P and Ca×P. (r=0.30、r=0.31, repectively)。It is concluded that a higher serum [PPi] was observed in uremia patients compared with hamodialysis patients and normal subjects, and the reason was unknown. The relationships between serum NTPPPH activity and serum [PPi] and P, Ca×P suggesting that NTPPPH could contribute to ectopic calcification by coacting with ALP.
Pyrophosphate (PPi) is a known inhibitor of hydroxyapatite formation and has been shown to inhibit medial vascular calcification in vitamin D–toxic rats. It was demonstrated recently that endogenous production of PPi prevents calcification of rat aorta that are cultured in high concentrations of calcium and phosphate. To determining whether PPi metabolism is altered in ESRD and hemodialysis patients, plasma levels PPi and its relative metabolic enzymes, namely nucleotide pyrophosphohydrolase(NTPPPH) and alkaline phosphatase(ALP) were measured in the ESRD and stable hemodialysis patients. And the relationship between the metabolism of PPi and the disorders of bone and mineral were analyzed. The serum [PPi] was 1.99±0.14μmmol/ml in 38 clinically stable hemodialysis patients and 2.08±0.23μmmol/ml in 28 uremia patients compared with 2.00±0.17μmmol/ml in 22 normal subjects (P > 0.05, P < 0.05, respectively). The serum NTPPPH activity was 23.84±4.18 U/ml in 38 clinically stable hemodialysis patients and 21.61±5.18 U/ml in 28 uremia patients compared with 20.34±5.24 U/ml in 22 normal subjects (P <0.01, P > 0.05, respectively). The ALP was highest in hemodialysis patients, uremia patients took second place compared with normal subjects. (P <0.05, P < 0.05, respectively). There was a inverse correlation between PPi level and NTPPPH.(r=-0.35)A positive relationship was observed between NTPPPH activity and serum P and Ca×P. (r=0.30、r=0.31, repectively)。It is concluded that a higher serum [PPi] was observed in uremia patients compared with hamodialysis patients and normal subjects, and the reason was unknown. The relationships between serum NTPPPH activity and serum [PPi] and P, Ca×P suggesting that NTPPPH could contribute to ectopic calcification by coacting with ALP.
引文
1.中泽了一.尿毒症?慢性透析にみられる合并症と关连する诸物质.临床透析Vol.21 No.9
2. Rachow JW, Ryan LM. Inorganic pyrophosphate metabolism in arthritis. Rheum Dis Clin North Am, 1988,14:289-302.
3. Russell RGG, Bisaz S, Fleisch H: Pyrophosphate and diphosphates in calcium metabolism and their possible role in renal failure. Arch Intern Med 124: 571–575, 1969
4. Silcox DC, McCarty DJ: Measurement of inorganic pyrophosphate in biologic fluids. Elevated levels in some patients with osteoarthritis, pseudogout, acromegaly, and uremia. J Clin Invest 52: 1863–1870, 1973
5.藤本清一,清野佳纪.骨形成マ—カ—.内科,1995,76:848.
6. Murray J. Favus. Primer on the Metabolic Bone Diseases and Disorders of the Mineral Metabolism. Fourth Edition. LIPPINCOTT WILLIAMS & WILKINS. Philadelpia,USA, 1999.
7.中村敏子,植田初江,铃木ちぐれ等.持续透析患者尸检病例血管病变的病理学探讨—与心肌梗塞患者的比较—.The Journal of Japanese College of Angiology Vol. 46, 2006, 675-679
8. Siegel, S. A., Hummel, C. F., and Carty, R. P. (1983) J. Biol. Chem. 258, 8601-8607 (Bonucci, E. (1967) J. Ultrastruct. Res. 20, 33-50
9. Hsu, H. H. (1983) J. Biol. Chem. 258, 3463-3468
10. Siegel, S. A., Hummel, C. F., and Carty, R. P. (1983) J. Biol. Chem. 258, 8601-8607
11. McCormick MM, Rahimi F, Bobryshev YV, et al. S100A8 and S100A9 in human arterial wall. Implications for atherogenesis. J Biol Chem, 2005,280:41521-9.
12. Fitzpatrick, L. A., Severson, A., Edwards, W. D., and Ingram, R. T. (1994) J. Clin. Investig. 94, 1597-1604
13. Howell DS, Martel-Pelletier J, Pelletier JP, et al. NTP pyrophosphohydrolase in human chondrocalcinotic and osteoarthritic cartilage. II. Further studies on histologic and subcellular distribution. Arthritis Rheum, 1984,27:193-9.
14. Oyajobi BO, Russell RG, Caswell AM. Modulation of ecto-nucleoside triphosphate pyrophosphatase activity of human osteoblast-like bone cells by 1alpha,25-dihydroxyvitamin D3, 24R,25-dihydroxyvitamin D3, parathyroid hormone, and dexamethasone. J Bone Miner Res, 1994,9:1259-66.
15. Rebbe NF, Tong BD, Finley EM, et al. Identification of nucleotide pyrophosphatase/alkaline phosphodiesterase I activity associated with the mouse plasma cell differentiation antigen PC-1. Proc Natl Acad Sci U S A, 1991,88:5192-6.
16. Belli SI, Goding JW. Biochemical characterization of human PC-1, an enzyme possessing alkaline phosphodiesterase I and nucleotide pyrophosphatase activities. Eur J Biochem, 1994,226:433-43.
17. Chern CJ, MacDonald AB, Morris AJ. Purification and properties of a nucleoside triphosphate pyrophosphohydrolase from red cells of the rabbit. J Biol Chem. 1969 Oct 25;244(20):5489–5495.
18. Haugen HF, Skrede S. Nucleotide pyrophosphatase and phosphodiesterase. I. Organ distribution and activities in body fluids. Clin Chem. 1977 Sep;23(9):1531–1537.
19. Yano T, Horie K, Kanamoto R, Kitagawa H, Funakoshi I, Yamashina I. Immunoaffinity purification and characterization of nucleotide pyrophosphatase from human placenta. Biochem Biophys Res Commun. 1987 Sep 30;147(3):1061–1069.
20. Che M, Nishida T, Gatmaitan Z, Arias IM. A nucleoside transporter is functionally linked to ectonucleotidases in rat liver canalicular membrane. J Biol Chem. 1992 May 15;267(14):9684–9688
21. Terkeltaub RA: Inorganic pyrophosphate generation and disposition in pathology. Am J Physiol 281: C1–C11, 2001
22. Rasmussen H: Hypophosphatasia; in Stanburry JB, Wijngaarden LP, Frederickson DS, Goldstein JL, Brown MS (eds): The Metabolic Basis of Inherited Disease. New York, McGraw-Hill, 1983, pp 1497-1507.
23. Narisawa S, Fro¨hlander N, and Milla′n JL. Inactivation of two mouse alkaline phosphatase genes and establishment of a mouse model of infantile hypophosphatasia. Dev Dyn 208: 432– 446, 1997.
24. Whyte MP. Hypophosphatasia and the role of alkaline phosphatase in skeletal mineralization. Endocr Rev 15: 439–461, 1994.
25. Zurutuza L, Muller F, Gibrat JF, Taillandier A, Simon-Bouy B, Serre JL, and Mornet E. Correlations of genotype and phenotype in hypophosphatasia. Human Mol Genet 8:1039– 1046, 1999.
26. Anderson HC, Hsu HH, Morris DC, Fedde KN, and Whyte MP. Matrix vesicles in osteomalacic hypophosphatasia bone contain apatite-like mineral crystals. Am J Pathol 151: 1555– 1561, 1997.
27. Hsu HHT and Anderson HC. Evidence of the presence of a specific ATPase responsible for ATP-initiated calcification by matrix vesicles isolated from cartilage and bone. J Biol Chem 271: 26383–26388, 1996.
28. Shibata H, Fukushi M, Misumi Y, Ikehara Y, Ohashi Y, and Oda K. Defective intracellular transport of tissue-nonspecific alkaline phosphatase with an Ala162Thr mutation associated with lethal hypophosphatasia. J Biochem 123: 968–977, 1998.
29. Khoslas,Kleerekoper M.Biochemical markers of bone turnover.Primer on the metabolic bone in diseases and disorders of mineral metabolism.4th ed,Favus MJ.eds.Williams & Wilkins,1999,128.
30. Yano T, Horie K, Kanamoto R, Kitagawa H, Funakoshi I, Yamashina I. Immunoaffinity purification and characterization of nucleotide pyrophosphatase from human placenta. Biochem Biophys Res Commun. 1987 Sep 30;147(3):1061–1069.
31. Che M, Nishida T, Gatmaitan Z, Arias IM. A nucleoside transporter is functionally linked to ectonucleotidases in rat liver canalicular membrane. J Biol Chem. 1992 May 15;267(14):9684–9688
32. Lomashvili KA, Khawandi W, O'Neill WC. Reduced plasma pyrophosphate levels in hemodialysis patients. J Am Soc Nephrol, 2005,16:2495-500.
1.わが国の透析慢性透析療法の現況. 2001年末,日本透析医学会.
2.原茂子,香取秀幸,乳原善文.糖尿病に起因する合併症ー慢性合併症末期糖尿病性腎症に対する透析療法と問題点.新時代の糖尿病学(4).日本臨牀2000; 60(増刊):306-15.
3. Block GA, Port FK. Re-evaluation of risks associated with hyperphosphatemia and hyperparathyroidism in dialysis patients: recommendations for a change in management. Am J Kidney Dis 2000; 35(6):1226-36.
4. Slatopolosky EA, Burke SK, Dillon MA, and The Rena Gel? Study Group. Rena Gel? a non absorbed calcium–andaluminium–free phosphate binder, lowers serum phosphorus and parathyroid hormone. Kidney Int 1999; 55:299-307.
5. Bergstrom J, at al. Malnutrition, cardiac disease, and mortality: an integrated point of view. Am J Kid Dis 1998; 32(5):834-41.
6. Gejyo F, Yamada T, Odani S, et al. A new form of amyloid protein associated with chronic hemodialysis was identified as microglobulin. Biochem Biophy Res Commun 1985; 129:701-6.
7. Miyata T, Inagi R, Iida Y, et al. Inovolement ofβ2-microglobulin modified with advanced glycation end products in the pathogenesis of hemodialysis-associated amyloidosis. Induction of human monocyte chemotaxsis and macrophage secretion of tumor necrosis factor and interleukin-1. J Clin Invast 1994; 93: 521-8.
8. Kristian K,Yres D,Sandrine M et al."Uremic Cardiomyopathy”Nephrol Dial Transplant,1998,13(Suppl 4):39
9. Shanahan CM, Cary NRB, Salisbury JR, Proudfoot D, Weissberg PL, Edmonds ME: Medial localization of mineralization-regulating proteins in association with Monckeberg's sclerosis: Evidence for smooth muscle cell-mediated vascular calcification. Circulation 100: 2168-2176, 1999
10. Jeziorska M, McCollum C, Woolley DE: Calcification in atherosclerotic plaque ofhuman carotid arteries:Associations with mast cells and macrophages. J Pathol 185: 10-17, 1998
11. Ibels LS, Alfrey AC, Huffer WE, Craswell PW, Anderson JT, Weil R: Arterial calcification and pathology in uremic patients undergoing dialysis. Am J Med 66: 790-796, 1979
12. Ejerblad S, Ericsson JLE, Erikson I: Arterial lesions of the radial artery in uraemic patients. Acta Chir Scand 145: 415-428, 1979
13. Everhart JE, Pettitt DJ, Knowler WC, Rose FA, Bennett PH: Medial arterial calcification and its association with mortality and complications of diabetes. Diabetologia 31: 16-23, 1988
14.田军,张金元,胡大勇.高龄尿毒症患者血液透析的临床探讨.中国中西医结合肾病杂志; 2005 Vol.6 No.9 P.526-528
15.中泽了一.尿毒症?慢性透析にみられる合并症と关连する诸物质.临床透析Vol.21 No.9
16.中村敏子,植田初江,铃木ちぐれ等.持续透析患者尸检病例血管病变的病理学探讨—与心肌梗塞患者的比较—.The Journal of Japanese College of Angiology Vol. 46, 2006, 675-679
17. Carlson AP, Yonas HM, Turner PT. Disorders of tumoral calcification of the spine: illustrative case study and review of the literature. J Spinal Disord Tech, 2007,20:97-103.
18. Hamada J, Tamai K, Ono W, et al. Uremic tumoral calcinosis in hemodialysis patients: clinicopathological findings and identification of calcific deposits. J Rheumatol, 2006,33:119-26.
19. Franco M, Albano L, Gaid H, et al. Resolution of tumoral calcinosis in a hemodialysis patient using low calcium dialysate. Joint Bone Spine, 2005,72:95-7
20. Mumme T, Griefingholt H, Schmidt-Rohlfing B, et al. [Teutschlander disease. A rare benign differential diagnosis of proliferative space-occupying lesions in theperiarticular soft tissue]. Orthopade, 2004,33:829-35.
21. Baums MH, Klinger HM, Otte S. Morbus Teutschlander - a massive soft-tissue calcification of the foot in a patient on long-term hemodialysis. Arch Orthop Trauma Surg, 2003,123:51-3.
22. Garcia S, Cofan F, Fernandez de RP, et al. Uremic tumoral calcinosis of the foot mimicking infection. Foot Ankle Int, 2002,23:260-3.
23. Ben Taarit C, el Younsi F, Turki S, et al. [Tumorous calcinosis in hemodialysis: anatomo-clinical study apropos of 3 cases]. Nephrologie, 2001,22:349-52.
24. Apostolou T, Tziamalis M, Christodoulidou C, et al. Regression of massive tumoral calcinosis of the ischium in a dialysis patient after treatment with reduced calcium dialysate and i.v. administration. Clin Nephrol, 1998,50:247-51
25. Minisola S, Romagnoli E, Rosso R. Massive tumoral calcinosis in a patient on long-term hemodialysis. J Bone Miner Res, 2000,15:2056-7.
26. Garcia S, Cofan F, Combalia A, et al. [Compression of the sciatic nerve in uremic tumor calcinosis]. Neurologia, 1999,14:86-9.
27. Pecovnik-Balon B, Kramberger S. Tumoral calcinosis in patients on hemodialysis. Case report and review of the literature. Am J Nephrol, 1997,17:93-5
28. Franco M, Van Elslande L, Passeron C, et al. Tumoral calcinosis in hemodialysis patients. A review of three cases. Rev Rhum Engl Ed, 1997,64:59-62.
29. Papadakis JT, Patrikarea A, Digenis GE, et al. Sodium thiosulfate in the treatment of tumoral calcifications in a hemodialysis patient without hyperparathyroidism. Nephron, 1996,72:308-12.
30. Blattert TR, Weckbach A. [Tumorous calcinosis (Teutschlander disease)]. Chirurg, 1993,64:592-4.
31. Kyriakopoulos G, Kontogianni K. Sodium thiosulfate treatment of tumoral calcinosis in patients with end-stage renal disease. Ren Fail, 1990,12:213-9
32. Fawthrop FW, Russell RGG. Ectopic calcification and ossification. In: NordinBEC,Need AG,Morris HA, eds. Metabolic bone and stone disease.3rd ed. Edinburgh: Churchill Livingstone,1993:325-338
33. Anderson HC,Calcific disease: a concept.Arch Pathol Lab Med;1983;107:341-348
34. Harrison HE, Harrison HC. Disorder of calcium and phosphate metabolism in childhood and adolescence. Philadelphia: WB Saunders,1979:291-304
35. Kuzela DC, Huffer WE, Conger JD, et al. Soft tissue calcification in chronic dialysis patients. Am J Pathol JT, 1977,86:403-24.
36. Milliner DS, Zinsmeister AR, Lieberman E, et al. Soft tissue calcification in pediatric patients with end-stage renal disease. Kidney Int JT - Kidney international, 1990,38:931-6.
37.汪关煜,钱莹,朱萍等.慢性肾衰患者甲状旁腺激素与左心室结构和功能的关系肾脏病与透析肾移植杂志2001 Vol.10 No.1 25-27
38. Nakagawa K. [A study of aortic calcification uremia]. Nippon Jinzo Gakkai Shi, 1997,39:135-43.
39. Tokuyama T, Ikeda T, Sato K, et al. Conjunctival and corneal calcification and bone metabolism in hemodialysis patients. Am J Kidney Dis, 2002,39:291-6.
40. Wei M, Esbaei K, Bargman J, et al. Relationship between serum magnesium, parathyroid hormone, and vascular calcification in patients on dialysis: a literature review. Perit Dial Int, 2006,26:366-73.
41. Hujairi NM,Afzali B, Goldsmith DJ. Cardiac calcification in renal patients: what we do and don’t know. Am J Kidney Dis, 2004, 43 ( 2) : 234–243
42. Ketteler M,Wanner C,Metzger T, et al. Deficiencies of calcium - regulatory p roteins in dialysis patients: a novel concep t of cardiovascular calcification in uremia. Kidney Int, 2003, Supp l 84: 84–87
43. Luo G, Ducy P, McKee MD, Pinero GJ, Loyer E, Behringer RR, Karsenty G: Spontaneous calcification of arteries and cartilage in mice lacking matrix Gla protein. Nature 386: 78-81, 1997
44. Price PA, Faus SA, Williamson MK: Warfarin causes rapid calcification of the elastic lamella in rat arteries and heart valves. Arterioscler Thromb Vasc Biol 18: 1400-1407, 1998
45. Ahmed S, O'Neill KD, Hood AF, Evan AP, Moe SM: Calciphylaxis Is associated with hyperphosphatemia and increased osteopontin expression by vascular smooth muscle cells. Am J Kidney Dis 37: 1267-1276, 2001
46. Denhardt DT, Guo X: Osteopontin: A protein with diverse functions. FASEB J 7: 1475-1482, 1993
47. Wada T, McKee MD, Steitz S, Giachelli CM: Calcification of vascular smooth muscle cell cultures. Inhibition by osteopontin. Circ Res 84: 166-178, 1999
48. Jono S, Peinado C, Giachelli CM: Phosphorylation of osteopontin is required for inhibition of vascular smooth muscle cell calcification. J Biol Chem 275: 20197-20203, 2000
49. Speer MY, McKee MD, Guldberg RE, Liaw L, Yang H-Y, Tung E, Karsenty G, Giachelli CM: Inactivation of the osteopontin gene enhances vascular calcification of matrix Gla protein-deficient mice: Evidence for osteopontin as an inducible inhibitor of vascular calcification in vivo. J Exp Med 196: 1047-1055, 2002
50. Min H, Morony S, Sarosi I, Dunstan CR, Caparelli C, Scully S, Van G, Kaufman S, Kostenuik PJ, Lacey DL, Boyle WJ, Simonet WS: Osteoprotegerin reverses osteoporosis by inhibiting endosteal osteoclasts and prevents vascular calcification by blocking a process resembling osteoclastogenesis. J Exp Med 192: 463-474, 2000
51. Bucay N, Sarosi I, Dunstan C, Moroney S, Tarpley J, Capparelli C, Scully S, Tan HL, Xu W, Lacey DL, Boyle WJ, Simonet WS: Osteoprotegerin-deficient mice develop early onset osteoporosis and arterial calcification. Genes Dev 12: 1260-1268, 1998
52. Jahnen-Dechent W, Schinke T, Trindl A, Muller-Esterl W, Sablitzky F, Kaiser S, Blessing M: Cloning and targeted deletion of the mouse fetuin gene. J Biol Chem 272: 31496-31503, 1997
53. Schinke T, Amendt C, Trindl A, Poschke O, Muller-Esterl W, Jahnen-Dechent W: The serum protein a2-HS glycoprotein/fetuin inhibits apatite formation in vitro and in mineralizing calvaria cells. J Biol Chem 271: 20789-20796, 1996
54. Ketteler M,Bongartz P,Westenfeld R, et al. Association of low fetuin- A (AHSG) concentrations in serum with cardiovascularmortality in patients on dialysis: a cross - sectional study. Lancet, 2003, 361: 827- 833.
55. Maadawy S, Kaartinen MT, Schinke T, et al. Cartilage formationand calcification in arteries of mice lacking matrix Gla p rotein. Connect Tissue Res, 2003, 44, Supp l 1: 272– 278
56. Zebboudj AF, Shin V, Bostrom K. Matrix GLA p rotein and BMP– 2 regulate osteoinduction in calcifying vascular cells. J Cell Biochem, 2001, 90 (4) : 756 - 765
57. Haas M, Leko-Mohr Z, Roschger P, et al. Osteoprotegerin and parathyroid hormone as markers of high-turnover osteodystrophy and decreased bone mineralization in hemodialysis patients. Am J Kidney Dis, 2002,39:580-6.
58. Moe SM, Reslerova M, Ketteler M, et al. Role of calcification inhibitors in the pathogenesis of vascular calcification in chronic kidney disease (CKD). Kidney Int, 2005,67:2295-304.
59. London GM, Guerin AP,Marchais SJ, et al. Arterial media calcification in end - stage renal disease: impact on all - cause and cardiovas cularmortality. Nephrol Dial Transp lant, 2003, 18: 1731 - 1740.
60. El - Maadawy S, Kaartinen MT, Schinke T, et al. Cartilage formationand calcification in arteries of mice lacking matrix Gla p rotein. Connect Tissue Res, 2003, 44, Supp l 1: 272 - 278.
61. Westenfeld, Ralf, Jahnen - Dechent, et al. The effect of ultrapure dialysate on AHSG/ fetuin levels in hemodialysis patients. Oxford University Press, 2003, 18, Supp l 4: 701 - 702.
62. Ketteler M, Westenfeld R, Schlieper G, et al. Pathogenesis of vascular calcification indialysis patients. Clin Exp Nephrol,2005,9:265-70.
63. Imam AA, Mattoo TK, Kapur G, et al. Calciphylaxis in pediatric end-stage renal disease. Pediatr Nephrol (Berlin, Germany), 2005,20:1776-80
64. Ritz E. The clinical management of hyperphosphatemia. J Nephrol, 2005,18:221-8
65. Ogata H, Koiwa F, Shishido K, et al. Combination therapy with sevelamer hydrochloride and calcium carbonate in Japanese patients with long-term hemodialysis: alternative approach for optimal mineral management. Ther Apher Dial, 2005,9:11-5.
66. de Francisco AL. Secondary hyperparathyroidism: review of the disease and its treatment. Clin Ther, 2004,26:1976-93.
67. Jevtic V. Imaging of renal osteodystrophy. Eur J Radiol,2003,46:85-95
68. Albaaj F, Hutchison A. Hyperphosphataemia in renal failure: causes, consequences and current management. Drugs, 2003,63:577-9
69. Baums MH, Klinger HM, Otte S. Morbus Teutschlander - a massive soft-tissue calcification of the foot in a patient on long-term hemodialysis. Arch Orthop Trauma Surg, 2003,123:51-3.
70. Green JA, Green CR, Minott SD. Calciphylaxis treated with neurolytic lumbar sympathetic block: case report and review of the literature. Reg Anesth Pain Med, 2000,25:310-2
71. al-Homrany M, Grillo IA, al-Ghamdi B, et al. Diffuse pulmonary calcinosis and multiple soft tissue calcification in renal failure patient with pathological femoral fracture. Indian J Chest Dis Allied Sci, 1998,40:205-11.
72. Franco M, Van Elslande L, Passeron C, et al. Tumoral calcinosis in hemodialysis patients. A review of three cases. Rev Rhum Engl Ed (English ed.), 1997,64:59-62.
73. Jolles H, Johnson AC, Ell SR. Subcutaneous calcifications masquerading as pulmonary lesions in long-term hemodialysis. Review of nodular pulmonary opacities in the population undergoing hemodialysis. Chest, 1985,88:234-8.
74. Savazzi GM, Cusmano F, Degasperi T. Cerebral atrophy in patients on long-termregular hemodialysis treatment. Clin Nephrol, 1985,23:89-95.
75. Cassidy MJ, Owen JP, Ellis HA, et al. Renal osteodystrophy and metastatic calcification in long-term continuous ambulatory peritoneal dialysis. Q J Med, 1985,54:29-48.
76. Eastwood JB. Renal osteodystrophy--a radiological review. CRC Crit Rev Diagn Imaging, 1977,9:77-104.
77. Parfitt AM. Soft-tissue calcification in uremia. Arch Intern Med, 1969,124:544-56
78. Zebboudj AF,Shin V,Bostrom K.Matrix GLA protein and BMP -2regulate osteoinduction in calcifying vascular cells.J Cell Biochem,2001,90(4) :756 -765.
79. Price PA,Lim JE.The inhibition of calcium phosphate precipitation by fetuin is accompanied by the formation of a fetuin - mineral complex.J Biol Chem ,2003,278 (24) :22144 - 22152.
80. Ruminy P,Gangneux C,Claeyssens S,et al.Gene transcription in hepatocytes during the acute phase of a systemic inflammation:from teanscription factors to target genes.Inflamm Res,2001,50:383 -390.
81. Ombrellino M,Wang H,Yang H,et al.Fetuin,a negative acute phase protein,attenuates TNF systhesis and the innate inflammatory response to carrageenan.Shock ,2001,15:181 - 185.
82. Westenfeld,Ralf,Jahnen - Dechent,et al.The effect of ultrapure dialysate on AHSG/fetuin levels in hemodialysis patients.Oxford University Press,2003,18,Suppl 4:701 - 702.
83.王开,钱家麒,Peter Stenvinkel,等.终末期肾衰竭患者血清胎球蛋白A水平改变与临床预后的关系.中华肾病杂志,2005,21:72-75.
84. Hofbauer LC,Khosla S,Dunstan CR,et al.The roles of osteoprotegerin and osteoprotegerin ligand in the paracrine regulation of bone resorption.J Bone Miner Res,2000,15:2 - 12.
85. Zhang J,Fu M,Myles D,et al.PDGF induces osteoprotegerin expression in vascular smooth muscle cells by multiple signal pathways.FEBS Lett,2002,521:180 - 184.
86. Schoppet M,Sattler AM,Schaefer JR,et al.Increased osteoprotegerin serum levels in men with coronary artery disease.J Clin Endocrinol Metab,2003,88:1024 - 1028.
87. Crisaflli A,Micari A,Altavilla D,et al.Serum levels of osteoprotegerin and RANKL in patients with ST elevation acute myocardial infarction.Clin Sci (Lond) ,2005,109 (4):389 - 395.
88. Schoppet M,Schaefer JR,Hofbauer LC.Low serum levels of soluble RANK ligand are associated with the presence of coronary artery disease in men.Circulation,2003,107:e76.
89. Avbersek -Luznik I,Malesic I,Rus I,et al.Increased levels of osteoprotegerin in hemodialysis patients.Clin Chem Lab Med,2002,40:1019 - 1023.
2. Rachow JW, Ryan LM. Inorganic pyrophosphate metabolism in arthritis. Rheum Dis Clin North Am, 1988,14:289-302.
3. Russell RGG, Bisaz S, Fleisch H: Pyrophosphate and diphosphates in calcium metabolism and their possible role in renal failure. Arch Intern Med 124: 571–575, 1969
4. Silcox DC, McCarty DJ: Measurement of inorganic pyrophosphate in biologic fluids. Elevated levels in some patients with osteoarthritis, pseudogout, acromegaly, and uremia. J Clin Invest 52: 1863–1870, 1973
5.藤本清一,清野佳纪.骨形成マ—カ—.内科,1995,76:848.
6. Murray J. Favus. Primer on the Metabolic Bone Diseases and Disorders of the Mineral Metabolism. Fourth Edition. LIPPINCOTT WILLIAMS & WILKINS. Philadelpia,USA, 1999.
7.中村敏子,植田初江,铃木ちぐれ等.持续透析患者尸检病例血管病变的病理学探讨—与心肌梗塞患者的比较—.The Journal of Japanese College of Angiology Vol. 46, 2006, 675-679
8. Siegel, S. A., Hummel, C. F., and Carty, R. P. (1983) J. Biol. Chem. 258, 8601-8607 (Bonucci, E. (1967) J. Ultrastruct. Res. 20, 33-50
9. Hsu, H. H. (1983) J. Biol. Chem. 258, 3463-3468
10. Siegel, S. A., Hummel, C. F., and Carty, R. P. (1983) J. Biol. Chem. 258, 8601-8607
11. McCormick MM, Rahimi F, Bobryshev YV, et al. S100A8 and S100A9 in human arterial wall. Implications for atherogenesis. J Biol Chem, 2005,280:41521-9.
12. Fitzpatrick, L. A., Severson, A., Edwards, W. D., and Ingram, R. T. (1994) J. Clin. Investig. 94, 1597-1604
13. Howell DS, Martel-Pelletier J, Pelletier JP, et al. NTP pyrophosphohydrolase in human chondrocalcinotic and osteoarthritic cartilage. II. Further studies on histologic and subcellular distribution. Arthritis Rheum, 1984,27:193-9.
14. Oyajobi BO, Russell RG, Caswell AM. Modulation of ecto-nucleoside triphosphate pyrophosphatase activity of human osteoblast-like bone cells by 1alpha,25-dihydroxyvitamin D3, 24R,25-dihydroxyvitamin D3, parathyroid hormone, and dexamethasone. J Bone Miner Res, 1994,9:1259-66.
15. Rebbe NF, Tong BD, Finley EM, et al. Identification of nucleotide pyrophosphatase/alkaline phosphodiesterase I activity associated with the mouse plasma cell differentiation antigen PC-1. Proc Natl Acad Sci U S A, 1991,88:5192-6.
16. Belli SI, Goding JW. Biochemical characterization of human PC-1, an enzyme possessing alkaline phosphodiesterase I and nucleotide pyrophosphatase activities. Eur J Biochem, 1994,226:433-43.
17. Chern CJ, MacDonald AB, Morris AJ. Purification and properties of a nucleoside triphosphate pyrophosphohydrolase from red cells of the rabbit. J Biol Chem. 1969 Oct 25;244(20):5489–5495.
18. Haugen HF, Skrede S. Nucleotide pyrophosphatase and phosphodiesterase. I. Organ distribution and activities in body fluids. Clin Chem. 1977 Sep;23(9):1531–1537.
19. Yano T, Horie K, Kanamoto R, Kitagawa H, Funakoshi I, Yamashina I. Immunoaffinity purification and characterization of nucleotide pyrophosphatase from human placenta. Biochem Biophys Res Commun. 1987 Sep 30;147(3):1061–1069.
20. Che M, Nishida T, Gatmaitan Z, Arias IM. A nucleoside transporter is functionally linked to ectonucleotidases in rat liver canalicular membrane. J Biol Chem. 1992 May 15;267(14):9684–9688
21. Terkeltaub RA: Inorganic pyrophosphate generation and disposition in pathology. Am J Physiol 281: C1–C11, 2001
22. Rasmussen H: Hypophosphatasia; in Stanburry JB, Wijngaarden LP, Frederickson DS, Goldstein JL, Brown MS (eds): The Metabolic Basis of Inherited Disease. New York, McGraw-Hill, 1983, pp 1497-1507.
23. Narisawa S, Fro¨hlander N, and Milla′n JL. Inactivation of two mouse alkaline phosphatase genes and establishment of a mouse model of infantile hypophosphatasia. Dev Dyn 208: 432– 446, 1997.
24. Whyte MP. Hypophosphatasia and the role of alkaline phosphatase in skeletal mineralization. Endocr Rev 15: 439–461, 1994.
25. Zurutuza L, Muller F, Gibrat JF, Taillandier A, Simon-Bouy B, Serre JL, and Mornet E. Correlations of genotype and phenotype in hypophosphatasia. Human Mol Genet 8:1039– 1046, 1999.
26. Anderson HC, Hsu HH, Morris DC, Fedde KN, and Whyte MP. Matrix vesicles in osteomalacic hypophosphatasia bone contain apatite-like mineral crystals. Am J Pathol 151: 1555– 1561, 1997.
27. Hsu HHT and Anderson HC. Evidence of the presence of a specific ATPase responsible for ATP-initiated calcification by matrix vesicles isolated from cartilage and bone. J Biol Chem 271: 26383–26388, 1996.
28. Shibata H, Fukushi M, Misumi Y, Ikehara Y, Ohashi Y, and Oda K. Defective intracellular transport of tissue-nonspecific alkaline phosphatase with an Ala162Thr mutation associated with lethal hypophosphatasia. J Biochem 123: 968–977, 1998.
29. Khoslas,Kleerekoper M.Biochemical markers of bone turnover.Primer on the metabolic bone in diseases and disorders of mineral metabolism.4th ed,Favus MJ.eds.Williams & Wilkins,1999,128.
30. Yano T, Horie K, Kanamoto R, Kitagawa H, Funakoshi I, Yamashina I. Immunoaffinity purification and characterization of nucleotide pyrophosphatase from human placenta. Biochem Biophys Res Commun. 1987 Sep 30;147(3):1061–1069.
31. Che M, Nishida T, Gatmaitan Z, Arias IM. A nucleoside transporter is functionally linked to ectonucleotidases in rat liver canalicular membrane. J Biol Chem. 1992 May 15;267(14):9684–9688
32. Lomashvili KA, Khawandi W, O'Neill WC. Reduced plasma pyrophosphate levels in hemodialysis patients. J Am Soc Nephrol, 2005,16:2495-500.
1.わが国の透析慢性透析療法の現況. 2001年末,日本透析医学会.
2.原茂子,香取秀幸,乳原善文.糖尿病に起因する合併症ー慢性合併症末期糖尿病性腎症に対する透析療法と問題点.新時代の糖尿病学(4).日本臨牀2000; 60(増刊):306-15.
3. Block GA, Port FK. Re-evaluation of risks associated with hyperphosphatemia and hyperparathyroidism in dialysis patients: recommendations for a change in management. Am J Kidney Dis 2000; 35(6):1226-36.
4. Slatopolosky EA, Burke SK, Dillon MA, and The Rena Gel? Study Group. Rena Gel? a non absorbed calcium–andaluminium–free phosphate binder, lowers serum phosphorus and parathyroid hormone. Kidney Int 1999; 55:299-307.
5. Bergstrom J, at al. Malnutrition, cardiac disease, and mortality: an integrated point of view. Am J Kid Dis 1998; 32(5):834-41.
6. Gejyo F, Yamada T, Odani S, et al. A new form of amyloid protein associated with chronic hemodialysis was identified as microglobulin. Biochem Biophy Res Commun 1985; 129:701-6.
7. Miyata T, Inagi R, Iida Y, et al. Inovolement ofβ2-microglobulin modified with advanced glycation end products in the pathogenesis of hemodialysis-associated amyloidosis. Induction of human monocyte chemotaxsis and macrophage secretion of tumor necrosis factor and interleukin-1. J Clin Invast 1994; 93: 521-8.
8. Kristian K,Yres D,Sandrine M et al."Uremic Cardiomyopathy”Nephrol Dial Transplant,1998,13(Suppl 4):39
9. Shanahan CM, Cary NRB, Salisbury JR, Proudfoot D, Weissberg PL, Edmonds ME: Medial localization of mineralization-regulating proteins in association with Monckeberg's sclerosis: Evidence for smooth muscle cell-mediated vascular calcification. Circulation 100: 2168-2176, 1999
10. Jeziorska M, McCollum C, Woolley DE: Calcification in atherosclerotic plaque ofhuman carotid arteries:Associations with mast cells and macrophages. J Pathol 185: 10-17, 1998
11. Ibels LS, Alfrey AC, Huffer WE, Craswell PW, Anderson JT, Weil R: Arterial calcification and pathology in uremic patients undergoing dialysis. Am J Med 66: 790-796, 1979
12. Ejerblad S, Ericsson JLE, Erikson I: Arterial lesions of the radial artery in uraemic patients. Acta Chir Scand 145: 415-428, 1979
13. Everhart JE, Pettitt DJ, Knowler WC, Rose FA, Bennett PH: Medial arterial calcification and its association with mortality and complications of diabetes. Diabetologia 31: 16-23, 1988
14.田军,张金元,胡大勇.高龄尿毒症患者血液透析的临床探讨.中国中西医结合肾病杂志; 2005 Vol.6 No.9 P.526-528
15.中泽了一.尿毒症?慢性透析にみられる合并症と关连する诸物质.临床透析Vol.21 No.9
16.中村敏子,植田初江,铃木ちぐれ等.持续透析患者尸检病例血管病变的病理学探讨—与心肌梗塞患者的比较—.The Journal of Japanese College of Angiology Vol. 46, 2006, 675-679
17. Carlson AP, Yonas HM, Turner PT. Disorders of tumoral calcification of the spine: illustrative case study and review of the literature. J Spinal Disord Tech, 2007,20:97-103.
18. Hamada J, Tamai K, Ono W, et al. Uremic tumoral calcinosis in hemodialysis patients: clinicopathological findings and identification of calcific deposits. J Rheumatol, 2006,33:119-26.
19. Franco M, Albano L, Gaid H, et al. Resolution of tumoral calcinosis in a hemodialysis patient using low calcium dialysate. Joint Bone Spine, 2005,72:95-7
20. Mumme T, Griefingholt H, Schmidt-Rohlfing B, et al. [Teutschlander disease. A rare benign differential diagnosis of proliferative space-occupying lesions in theperiarticular soft tissue]. Orthopade, 2004,33:829-35.
21. Baums MH, Klinger HM, Otte S. Morbus Teutschlander - a massive soft-tissue calcification of the foot in a patient on long-term hemodialysis. Arch Orthop Trauma Surg, 2003,123:51-3.
22. Garcia S, Cofan F, Fernandez de RP, et al. Uremic tumoral calcinosis of the foot mimicking infection. Foot Ankle Int, 2002,23:260-3.
23. Ben Taarit C, el Younsi F, Turki S, et al. [Tumorous calcinosis in hemodialysis: anatomo-clinical study apropos of 3 cases]. Nephrologie, 2001,22:349-52.
24. Apostolou T, Tziamalis M, Christodoulidou C, et al. Regression of massive tumoral calcinosis of the ischium in a dialysis patient after treatment with reduced calcium dialysate and i.v. administration. Clin Nephrol, 1998,50:247-51
25. Minisola S, Romagnoli E, Rosso R. Massive tumoral calcinosis in a patient on long-term hemodialysis. J Bone Miner Res, 2000,15:2056-7.
26. Garcia S, Cofan F, Combalia A, et al. [Compression of the sciatic nerve in uremic tumor calcinosis]. Neurologia, 1999,14:86-9.
27. Pecovnik-Balon B, Kramberger S. Tumoral calcinosis in patients on hemodialysis. Case report and review of the literature. Am J Nephrol, 1997,17:93-5
28. Franco M, Van Elslande L, Passeron C, et al. Tumoral calcinosis in hemodialysis patients. A review of three cases. Rev Rhum Engl Ed, 1997,64:59-62.
29. Papadakis JT, Patrikarea A, Digenis GE, et al. Sodium thiosulfate in the treatment of tumoral calcifications in a hemodialysis patient without hyperparathyroidism. Nephron, 1996,72:308-12.
30. Blattert TR, Weckbach A. [Tumorous calcinosis (Teutschlander disease)]. Chirurg, 1993,64:592-4.
31. Kyriakopoulos G, Kontogianni K. Sodium thiosulfate treatment of tumoral calcinosis in patients with end-stage renal disease. Ren Fail, 1990,12:213-9
32. Fawthrop FW, Russell RGG. Ectopic calcification and ossification. In: NordinBEC,Need AG,Morris HA, eds. Metabolic bone and stone disease.3rd ed. Edinburgh: Churchill Livingstone,1993:325-338
33. Anderson HC,Calcific disease: a concept.Arch Pathol Lab Med;1983;107:341-348
34. Harrison HE, Harrison HC. Disorder of calcium and phosphate metabolism in childhood and adolescence. Philadelphia: WB Saunders,1979:291-304
35. Kuzela DC, Huffer WE, Conger JD, et al. Soft tissue calcification in chronic dialysis patients. Am J Pathol JT, 1977,86:403-24.
36. Milliner DS, Zinsmeister AR, Lieberman E, et al. Soft tissue calcification in pediatric patients with end-stage renal disease. Kidney Int JT - Kidney international, 1990,38:931-6.
37.汪关煜,钱莹,朱萍等.慢性肾衰患者甲状旁腺激素与左心室结构和功能的关系肾脏病与透析肾移植杂志2001 Vol.10 No.1 25-27
38. Nakagawa K. [A study of aortic calcification uremia]. Nippon Jinzo Gakkai Shi, 1997,39:135-43.
39. Tokuyama T, Ikeda T, Sato K, et al. Conjunctival and corneal calcification and bone metabolism in hemodialysis patients. Am J Kidney Dis, 2002,39:291-6.
40. Wei M, Esbaei K, Bargman J, et al. Relationship between serum magnesium, parathyroid hormone, and vascular calcification in patients on dialysis: a literature review. Perit Dial Int, 2006,26:366-73.
41. Hujairi NM,Afzali B, Goldsmith DJ. Cardiac calcification in renal patients: what we do and don’t know. Am J Kidney Dis, 2004, 43 ( 2) : 234–243
42. Ketteler M,Wanner C,Metzger T, et al. Deficiencies of calcium - regulatory p roteins in dialysis patients: a novel concep t of cardiovascular calcification in uremia. Kidney Int, 2003, Supp l 84: 84–87
43. Luo G, Ducy P, McKee MD, Pinero GJ, Loyer E, Behringer RR, Karsenty G: Spontaneous calcification of arteries and cartilage in mice lacking matrix Gla protein. Nature 386: 78-81, 1997
44. Price PA, Faus SA, Williamson MK: Warfarin causes rapid calcification of the elastic lamella in rat arteries and heart valves. Arterioscler Thromb Vasc Biol 18: 1400-1407, 1998
45. Ahmed S, O'Neill KD, Hood AF, Evan AP, Moe SM: Calciphylaxis Is associated with hyperphosphatemia and increased osteopontin expression by vascular smooth muscle cells. Am J Kidney Dis 37: 1267-1276, 2001
46. Denhardt DT, Guo X: Osteopontin: A protein with diverse functions. FASEB J 7: 1475-1482, 1993
47. Wada T, McKee MD, Steitz S, Giachelli CM: Calcification of vascular smooth muscle cell cultures. Inhibition by osteopontin. Circ Res 84: 166-178, 1999
48. Jono S, Peinado C, Giachelli CM: Phosphorylation of osteopontin is required for inhibition of vascular smooth muscle cell calcification. J Biol Chem 275: 20197-20203, 2000
49. Speer MY, McKee MD, Guldberg RE, Liaw L, Yang H-Y, Tung E, Karsenty G, Giachelli CM: Inactivation of the osteopontin gene enhances vascular calcification of matrix Gla protein-deficient mice: Evidence for osteopontin as an inducible inhibitor of vascular calcification in vivo. J Exp Med 196: 1047-1055, 2002
50. Min H, Morony S, Sarosi I, Dunstan CR, Caparelli C, Scully S, Van G, Kaufman S, Kostenuik PJ, Lacey DL, Boyle WJ, Simonet WS: Osteoprotegerin reverses osteoporosis by inhibiting endosteal osteoclasts and prevents vascular calcification by blocking a process resembling osteoclastogenesis. J Exp Med 192: 463-474, 2000
51. Bucay N, Sarosi I, Dunstan C, Moroney S, Tarpley J, Capparelli C, Scully S, Tan HL, Xu W, Lacey DL, Boyle WJ, Simonet WS: Osteoprotegerin-deficient mice develop early onset osteoporosis and arterial calcification. Genes Dev 12: 1260-1268, 1998
52. Jahnen-Dechent W, Schinke T, Trindl A, Muller-Esterl W, Sablitzky F, Kaiser S, Blessing M: Cloning and targeted deletion of the mouse fetuin gene. J Biol Chem 272: 31496-31503, 1997
53. Schinke T, Amendt C, Trindl A, Poschke O, Muller-Esterl W, Jahnen-Dechent W: The serum protein a2-HS glycoprotein/fetuin inhibits apatite formation in vitro and in mineralizing calvaria cells. J Biol Chem 271: 20789-20796, 1996
54. Ketteler M,Bongartz P,Westenfeld R, et al. Association of low fetuin- A (AHSG) concentrations in serum with cardiovascularmortality in patients on dialysis: a cross - sectional study. Lancet, 2003, 361: 827- 833.
55. Maadawy S, Kaartinen MT, Schinke T, et al. Cartilage formationand calcification in arteries of mice lacking matrix Gla p rotein. Connect Tissue Res, 2003, 44, Supp l 1: 272– 278
56. Zebboudj AF, Shin V, Bostrom K. Matrix GLA p rotein and BMP– 2 regulate osteoinduction in calcifying vascular cells. J Cell Biochem, 2001, 90 (4) : 756 - 765
57. Haas M, Leko-Mohr Z, Roschger P, et al. Osteoprotegerin and parathyroid hormone as markers of high-turnover osteodystrophy and decreased bone mineralization in hemodialysis patients. Am J Kidney Dis, 2002,39:580-6.
58. Moe SM, Reslerova M, Ketteler M, et al. Role of calcification inhibitors in the pathogenesis of vascular calcification in chronic kidney disease (CKD). Kidney Int, 2005,67:2295-304.
59. London GM, Guerin AP,Marchais SJ, et al. Arterial media calcification in end - stage renal disease: impact on all - cause and cardiovas cularmortality. Nephrol Dial Transp lant, 2003, 18: 1731 - 1740.
60. El - Maadawy S, Kaartinen MT, Schinke T, et al. Cartilage formationand calcification in arteries of mice lacking matrix Gla p rotein. Connect Tissue Res, 2003, 44, Supp l 1: 272 - 278.
61. Westenfeld, Ralf, Jahnen - Dechent, et al. The effect of ultrapure dialysate on AHSG/ fetuin levels in hemodialysis patients. Oxford University Press, 2003, 18, Supp l 4: 701 - 702.
62. Ketteler M, Westenfeld R, Schlieper G, et al. Pathogenesis of vascular calcification indialysis patients. Clin Exp Nephrol,2005,9:265-70.
63. Imam AA, Mattoo TK, Kapur G, et al. Calciphylaxis in pediatric end-stage renal disease. Pediatr Nephrol (Berlin, Germany), 2005,20:1776-80
64. Ritz E. The clinical management of hyperphosphatemia. J Nephrol, 2005,18:221-8
65. Ogata H, Koiwa F, Shishido K, et al. Combination therapy with sevelamer hydrochloride and calcium carbonate in Japanese patients with long-term hemodialysis: alternative approach for optimal mineral management. Ther Apher Dial, 2005,9:11-5.
66. de Francisco AL. Secondary hyperparathyroidism: review of the disease and its treatment. Clin Ther, 2004,26:1976-93.
67. Jevtic V. Imaging of renal osteodystrophy. Eur J Radiol,2003,46:85-95
68. Albaaj F, Hutchison A. Hyperphosphataemia in renal failure: causes, consequences and current management. Drugs, 2003,63:577-9
69. Baums MH, Klinger HM, Otte S. Morbus Teutschlander - a massive soft-tissue calcification of the foot in a patient on long-term hemodialysis. Arch Orthop Trauma Surg, 2003,123:51-3.
70. Green JA, Green CR, Minott SD. Calciphylaxis treated with neurolytic lumbar sympathetic block: case report and review of the literature. Reg Anesth Pain Med, 2000,25:310-2
71. al-Homrany M, Grillo IA, al-Ghamdi B, et al. Diffuse pulmonary calcinosis and multiple soft tissue calcification in renal failure patient with pathological femoral fracture. Indian J Chest Dis Allied Sci, 1998,40:205-11.
72. Franco M, Van Elslande L, Passeron C, et al. Tumoral calcinosis in hemodialysis patients. A review of three cases. Rev Rhum Engl Ed (English ed.), 1997,64:59-62.
73. Jolles H, Johnson AC, Ell SR. Subcutaneous calcifications masquerading as pulmonary lesions in long-term hemodialysis. Review of nodular pulmonary opacities in the population undergoing hemodialysis. Chest, 1985,88:234-8.
74. Savazzi GM, Cusmano F, Degasperi T. Cerebral atrophy in patients on long-termregular hemodialysis treatment. Clin Nephrol, 1985,23:89-95.
75. Cassidy MJ, Owen JP, Ellis HA, et al. Renal osteodystrophy and metastatic calcification in long-term continuous ambulatory peritoneal dialysis. Q J Med, 1985,54:29-48.
76. Eastwood JB. Renal osteodystrophy--a radiological review. CRC Crit Rev Diagn Imaging, 1977,9:77-104.
77. Parfitt AM. Soft-tissue calcification in uremia. Arch Intern Med, 1969,124:544-56
78. Zebboudj AF,Shin V,Bostrom K.Matrix GLA protein and BMP -2regulate osteoinduction in calcifying vascular cells.J Cell Biochem,2001,90(4) :756 -765.
79. Price PA,Lim JE.The inhibition of calcium phosphate precipitation by fetuin is accompanied by the formation of a fetuin - mineral complex.J Biol Chem ,2003,278 (24) :22144 - 22152.
80. Ruminy P,Gangneux C,Claeyssens S,et al.Gene transcription in hepatocytes during the acute phase of a systemic inflammation:from teanscription factors to target genes.Inflamm Res,2001,50:383 -390.
81. Ombrellino M,Wang H,Yang H,et al.Fetuin,a negative acute phase protein,attenuates TNF systhesis and the innate inflammatory response to carrageenan.Shock ,2001,15:181 - 185.
82. Westenfeld,Ralf,Jahnen - Dechent,et al.The effect of ultrapure dialysate on AHSG/fetuin levels in hemodialysis patients.Oxford University Press,2003,18,Suppl 4:701 - 702.
83.王开,钱家麒,Peter Stenvinkel,等.终末期肾衰竭患者血清胎球蛋白A水平改变与临床预后的关系.中华肾病杂志,2005,21:72-75.
84. Hofbauer LC,Khosla S,Dunstan CR,et al.The roles of osteoprotegerin and osteoprotegerin ligand in the paracrine regulation of bone resorption.J Bone Miner Res,2000,15:2 - 12.
85. Zhang J,Fu M,Myles D,et al.PDGF induces osteoprotegerin expression in vascular smooth muscle cells by multiple signal pathways.FEBS Lett,2002,521:180 - 184.
86. Schoppet M,Sattler AM,Schaefer JR,et al.Increased osteoprotegerin serum levels in men with coronary artery disease.J Clin Endocrinol Metab,2003,88:1024 - 1028.
87. Crisaflli A,Micari A,Altavilla D,et al.Serum levels of osteoprotegerin and RANKL in patients with ST elevation acute myocardial infarction.Clin Sci (Lond) ,2005,109 (4):389 - 395.
88. Schoppet M,Schaefer JR,Hofbauer LC.Low serum levels of soluble RANK ligand are associated with the presence of coronary artery disease in men.Circulation,2003,107:e76.
89. Avbersek -Luznik I,Malesic I,Rus I,et al.Increased levels of osteoprotegerin in hemodialysis patients.Clin Chem Lab Med,2002,40:1019 - 1023.