"1"^^ . "http://www.vnitrnilekarstvi.cz/pdf?id=39325" . . . "Metabolizmus vitaminu D a sou\u010Dasn\u00E9 mo\u017Enosti terapeutick\u00E9 aktivace receptoru pro vitamin D p\u0159i chronick\u00E9m onemocn\u011Bn\u00ED a selh\u00E1n\u00ED ledvin" . "Chronick\u00E9 onemocn\u011Bn\u00ED ledvin (CKD) a zejm\u00E9na chronick\u00E9 selh\u00E1n\u00ED ledvin je spojeno s deficitem vitaminu D a s poruchou v\u0161ech metabolick\u00FDch proces\u016F, kter\u00E9 se k vitaminu D v organizmu vztahuj\u00ED. Hladiny kalcidiolu jsou \u010Dasto n\u00EDzk\u00E9. V sou\u010Dasn\u00E9 dob\u011B je v\u011Bnov\u00E1na pozornost jejich stanoven\u00ED i jejich farmakologick\u00E9 \u00FAprav\u011B, kter\u00E1 m\u016F\u017Ee p\u0159isp\u011Bt ke zv\u00FD\u0161en\u00ED dostupnosti substr\u00E1tu pro extraren\u00E1ln\u00ED produkci kalcitriolu. Tvorba kalcitriolu je u pacient\u016F s CKD sn\u00ED\u017Eena, a to nejen v d\u016Fsledku zanikaj\u00EDc\u00EDho funk\u010Dn\u00EDho ren\u00E1ln\u00EDho parenchymu, ale i v d\u016Fsledku \u00FAtlumu 1-alfa-hydroxyl\u00E1zy p\u016Fsoben\u00EDm FGF-23 a dal\u0161\u00EDch vliv\u016F. Naopak, parathormon (PTH) ren\u00E1ln\u00ED tvorbu kalcitriolu zvy\u0161uje, av\u0161ak za cenu sekund\u00E1rn\u00ED hyperparatyre\u00F3zy. V l\u00E9\u010Db\u011B sekund\u00E1rn\u00ED hyperparatyre\u00F3zy se vyu\u017E\u00EDv\u00E1 syntetick\u00FD kalcitriol (\u010Di alfa-kalcidol), kter\u00FD suprimuje tvorbu PTH. Tento postup je \u010Dasto spojen s ne\u017E\u00E1douc\u00EDm zv\u00FD\u0161en\u00EDm kalcemie i fosfatemie, nebo\u0165 efekt na p\u0159\u00ED\u0161t\u00EDtn\u00E1 t\u011Bl\u00EDska je spojen s \u00FA\u010Dinkem v za\u017E\u00EDvac\u00EDm traktu, kde se vst\u0159eb\u00E1v\u00E1n\u00ED kalcia i fosforu vlivem kalcitriolu zvy\u0161uje. Syntetick\u00E1 analoga vitaminu D p\u0159edstavuj\u00ED terapeutick\u00FD postup, kter\u00FD inhibuje p\u0159\u00ED\u0161t\u00EDtn\u00E1 t\u011Bl\u00EDska p\u0159i v\u00FDznamn\u011B ni\u017E\u0161\u00EDm \u00FA\u010Dinku v za\u017E\u00EDvac\u00EDm traktu. Selektivn\u00EDm aktiv\u00E1torem VDR (receptor pro vitamin D) vyu\u017E\u00EDvan\u00FDm pro c\u00EDlenou supresi p\u0159\u00ED\u0161t\u00EDtn\u00FDch t\u011Bl\u00EDsek, je parikalcitol. Deficit vitaminu D v b\u011B\u017En\u00E9 populaci je spojen p\u0159inejmen\u0161\u00EDm v epidemiologick\u00FDch studi\u00EDch s celou \u0159adou medic\u00EDnsk\u00FDch komplikac\u00ED. Analogick\u00E1 spojitost je pozorov\u00E1na i u nefrologick\u00FDch pacient\u016F. V klinick\u00FDch observa\u010Dn\u00EDch studi\u00EDch je l\u00E9\u010Dba aktiv\u00E1tory VDR opakovan\u011B spojena s lep\u0161\u00ED progn\u00F3zou, c\u00EDlen\u00E9 randomizovan\u00E9 studie v\u0161ak nejsou k dispozici. Stejn\u011B jako v ostatn\u00EDch oborech medic\u00EDny, i v nefrologii je vitaminu D, resp. aktivaci receptoru pro vitamin D v sou\u010Dasn\u00E9 dob\u011B v\u011Bnov\u00E1na velk\u00E1 pozornost." . "1"^^ . "Vitamin D metabolism and current options for therapeutic activation of vitamin D receptor in patients with chronic kidney disease or renal failure"@en . "Chronic kidney disease (CKD), and chronic renal failure in particular, is associated with vitamin D deficiency and with a disorder of all metabolic processes that are associated with vitamin D. Calcidiol levels are often low. At present, efforts are made to test and to pharmacologically modulate its levels and thus to contribute to greater availability of the substrate for external calcitriol production. Calcitriol production is reduced in CKD patients not only as a consequence of diminishing functional renal parenchyma but also as a consequence of 1-alfa-hydroxylase inhibition by FGF-23 and other factors. On the other hand, although parathormone (PTH) increases renal production of calcitriol, it also causes secondary hyperparathyroidism. Synthetic calcitriol (or alfa-calcidiol) supresses PTH production and is used to treat secondary hyperparathyroidism. This approach is often associated with adverse increase in calcaemia and phosphataemia as the effect on parathyroid glands is associated with an effect on the gastrointestinal tract where calcium and phosphor absorption is increased by calcitriol. Synthetic analogues of vitamin D inhibit parathyroid gland but have significantly lower effect on gastrointestinal tract. Paricalcitol is a selective VDR (vitamin D receptor) activator, used for targeted suppression of parathyroid glands. Vitamin D deficiency in general population is associated, at least in epidemiological studies, with a range of medical complications and the same also applies to patients with renal disease. Although randomised studies are not available, clinical observational studies repeatedly showed treatment with VDR activators to be associated with better prognosis. As other fields of medicine, nephrology currently pays a great attention to vitamin D and vitamin D receptor activation."@en . . "Chronick\u00E9 onemocn\u011Bn\u00ED ledvin (CKD) a zejm\u00E9na chronick\u00E9 selh\u00E1n\u00ED ledvin je spojeno s deficitem vitaminu D a s poruchou v\u0161ech metabolick\u00FDch proces\u016F, kter\u00E9 se k vitaminu D v organizmu vztahuj\u00ED. Hladiny kalcidiolu jsou \u010Dasto n\u00EDzk\u00E9. V sou\u010Dasn\u00E9 dob\u011B je v\u011Bnov\u00E1na pozornost jejich stanoven\u00ED i jejich farmakologick\u00E9 \u00FAprav\u011B, kter\u00E1 m\u016F\u017Ee p\u0159isp\u011Bt ke zv\u00FD\u0161en\u00ED dostupnosti substr\u00E1tu pro extraren\u00E1ln\u00ED produkci kalcitriolu. Tvorba kalcitriolu je u pacient\u016F s CKD sn\u00ED\u017Eena, a to nejen v d\u016Fsledku zanikaj\u00EDc\u00EDho funk\u010Dn\u00EDho ren\u00E1ln\u00EDho parenchymu, ale i v d\u016Fsledku \u00FAtlumu 1-alfa-hydroxyl\u00E1zy p\u016Fsoben\u00EDm FGF-23 a dal\u0161\u00EDch vliv\u016F. Naopak, parathormon (PTH) ren\u00E1ln\u00ED tvorbu kalcitriolu zvy\u0161uje, av\u0161ak za cenu sekund\u00E1rn\u00ED hyperparatyre\u00F3zy. V l\u00E9\u010Db\u011B sekund\u00E1rn\u00ED hyperparatyre\u00F3zy se vyu\u017E\u00EDv\u00E1 syntetick\u00FD kalcitriol (\u010Di alfa-kalcidol), kter\u00FD suprimuje tvorbu PTH. Tento postup je \u010Dasto spojen s ne\u017E\u00E1douc\u00EDm zv\u00FD\u0161en\u00EDm kalcemie i fosfatemie, nebo\u0165 efekt na p\u0159\u00ED\u0161t\u00EDtn\u00E1 t\u011Bl\u00EDska je spojen s \u00FA\u010Dinkem v za\u017E\u00EDvac\u00EDm traktu, kde se vst\u0159eb\u00E1v\u00E1n\u00ED kalcia i fosforu vlivem kalcitriolu zvy\u0161uje. Syntetick\u00E1 analoga vitaminu D p\u0159edstavuj\u00ED terapeutick\u00FD postup, kter\u00FD inhibuje p\u0159\u00ED\u0161t\u00EDtn\u00E1 t\u011Bl\u00EDska p\u0159i v\u00FDznamn\u011B ni\u017E\u0161\u00EDm \u00FA\u010Dinku v za\u017E\u00EDvac\u00EDm traktu. Selektivn\u00EDm aktiv\u00E1torem VDR (receptor pro vitamin D) vyu\u017E\u00EDvan\u00FDm pro c\u00EDlenou supresi p\u0159\u00ED\u0161t\u00EDtn\u00FDch t\u011Bl\u00EDsek, je parikalcitol. Deficit vitaminu D v b\u011B\u017En\u00E9 populaci je spojen p\u0159inejmen\u0161\u00EDm v epidemiologick\u00FDch studi\u00EDch s celou \u0159adou medic\u00EDnsk\u00FDch komplikac\u00ED. Analogick\u00E1 spojitost je pozorov\u00E1na i u nefrologick\u00FDch pacient\u016F. V klinick\u00FDch observa\u010Dn\u00EDch studi\u00EDch je l\u00E9\u010Dba aktiv\u00E1tory VDR opakovan\u011B spojena s lep\u0161\u00ED progn\u00F3zou, c\u00EDlen\u00E9 randomizovan\u00E9 studie v\u0161ak nejsou k dispozici. Stejn\u011B jako v ostatn\u00EDch oborech medic\u00EDny, i v nefrologii je vitaminu D, resp. aktivaci receptoru pro vitamin D v sou\u010Dasn\u00E9 dob\u011B v\u011Bnov\u00E1na velk\u00E1 pozornost."@cs . . "149612" . "RIV/00023001:_____/12:00056097!RIV13-MZ0-00023001" . . . "I" . . . "Metabolizmus vitaminu D a sou\u010Dasn\u00E9 mo\u017Enosti terapeutick\u00E9 aktivace receptoru pro vitamin D p\u0159i chronick\u00E9m onemocn\u011Bn\u00ED a selh\u00E1n\u00ED ledvin" . "Dusilov\u00E1 - Sulkov\u00E1, Sylvie" . . . . "RIV/00023001:_____/12:00056097" . . . "11" . "Vitamin D metabolism and current options for therapeutic activation of vitamin D receptor in patients with chronic kidney disease or renal failure"@en . . . . "Vnit\u0159n\u00ED l\u00E9ka\u0159stv\u00ED" . . "CZ - \u010Cesk\u00E1 republika" . . "58" . "[66BDF13D38BA]" . . "Metabolizmus vitaminu D a sou\u010Dasn\u00E9 mo\u017Enosti terapeutick\u00E9 aktivace receptoru pro vitamin D p\u0159i chronick\u00E9m onemocn\u011Bn\u00ED a selh\u00E1n\u00ED ledvin"@cs . "Metabolizmus vitaminu D a sou\u010Dasn\u00E9 mo\u017Enosti terapeutick\u00E9 aktivace receptoru pro vitamin D p\u0159i chronick\u00E9m onemocn\u011Bn\u00ED a selh\u00E1n\u00ED ledvin"@cs . "0042-773X" . "calcitriol, calcidiol, paricalcitol, chronic kidney disease, chronic renal failure, vitamin D receptor, secondary hyperparathyroidism"@en . "11"^^ .