腎不全患者の骨病変に対する活性型ビタミンDの有効性と安全性

Treatment of Bone Diseases in ESRD Patients. The efficacy and safety of activated vitamin D for CKD-MBD.

　慢性腎臓病（CKD）の進行に伴い，二次性副甲状腺機能亢進症に代表される骨回転代謝異常が生じる。活性型ビタミンD製剤の投与により高骨回転型骨病変の改善が期待され，保存期および透析期CKDの骨ミネラル管理に広く用いられる。また，腎不全は続発性骨粗鬆症の原疾患であり，かつ原発性骨粗鬆症と高率に併存する。腎不全患者の骨粗鬆症においても活性型ビタミンD製剤の投与は骨量の上昇と転倒防止効果を介して骨折抑制効果をもたらすと考えられる。

　Metabolic bone disorders that are represented by secondary hyperparathyroidism occur with the progression of chronic kidney disease（CKD）. The administration of activated vitamin D is expected to improve high-turnover bone disorders and is widely used for the management of bone mineral diseases in patients with CKD and end-stage renal disease. CKD is an underlying disease of secondary osteoporosis and coexists with primary osteoporosis at a high rate. With regard to osteoporosis patients with renal insufficiency, the administration of activated vitamin D is also thought to reduce the fracture incidence by both increasing bone mass and reducing falls.