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CKD-MBD勉強会vol.3 CKD-MBD管理の謎
ビタミンDが
ビタミンDで
リンが上昇?
俺だってよく分かんないよ
だから勉強しようよ
リン管理のジレンマ
重要なのね
CKD-MBDの管理で一番最初にやらなければならないのは
リンの管理!!
基本はリン3.5~6.0で管理しながら
補正カルシウムを8.5~10.0に合わしていく
カルシウムの上昇過程でリンが上がる
WHAT’S?
リンを管理したいのに、リンが上がる原因
こいつ
カルシウムを吸収促進
リンも吸収促進( ;´Д`)
PTHの上昇過程でリンが上がる
こいつら破骨細胞
破骨細胞
低カルシウムによりPTHがあがると
Ca↑
Pリンもでる( ;´Д`)
しかも骨ボロボロ
そこで登場!シナカルセト!
Ca
P
PTH↓
骨芽細胞
シナカルセト服用でCa Pも下がる理由
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