小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 慢性肾病的特征
- 潜在吸收不良综合征特征
其他诊断因素
- 肌肉痉挛和骨痛
- 口周麻刺感或手指或脚趾感觉异常
- Chvostek 征
- 低钙束臂征
- 弓形腿或膝外翻
- 骨折
危险因素
- 年龄增加
- 慢性肾病
- 维生素 D 缺乏：日晒不足
- 营养性缺乏（尤其是膳食缺少乳制品和鱼）
- 维生素 D 缺乏：吸收不良
- 维生素 D 缺乏：肝功能障碍
- 维生素 D 缺乏：遗传病
- 维生素 D 缺乏：肥胖
- 用药
诊断性检查
首要检查
- 血清钙
- 血清全甲状旁腺激素水平 (iPTH)
- 血清肌酐
- 血清尿素
需考虑的检查
- 血清磷
- 血清 25 -羟基维生素 D
- 血清镁
- 颈部超声检查
- 甲氧基异丁基异腈扫描
- 颈部和上胸高分辨率增强 CT 扫描
- 颈部与上胸部 MRI 检查
治疗流程
缺少日光照射
吸收不良相关的
CKD 3 期至 5D 期
撰稿人
作者
Arif Khwaja, PhD FRCP
Consultant Nephrologist
Sheffield Kidney Institute
Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust
UK
利益声明
AK declares that he has no competing interests.
Syazrah Salam, MBChB MRCP PhD
Renal Registrar
Sheffield Kidney Institute
Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust
UK
利益声明
SS has received a research grant from Immunodiagnostic Systems via the University of Sheffield. SS is an author of an article cited in this topic.
鸣谢
Dr Arif Khwaja and Dr Syazrah Salam would like to gratefully acknowledge Dr Hugh Gallagher, Dr Louise Ross, Dr Brendan C. Stack Jr, Dr David J.A. Goldsmith, and Dr Kiran Haresh Kumar Patel, previous contributors to this topic.
利益声明
HG, LR, BCS, DJAG, and KHKP declare that they have no competing interests.
同行评议者
Fong-Fu Chou, MD
Department of Surgery
Chang Gung Memorial Hospital-Kaohsiung Medical Center
Chang Gung University College of Medicine
Kaohsiung Hsien
Taiwan
利益声明
Not disclosed.
Victor Schneider, MD
Clinical Associate Professor of Medicine
Uniformed Health Services University of the Health Sciences
Bethesda
MD
利益声明
VS declares that he has no competing interests.
鉴别诊断
- 原发性甲状旁腺功能亢进
更多 鉴别诊断指南
- 慢性肾病：评估和管理
- EANM 甲状旁腺成像实践指南
更多 指南
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