肾小管酸中毒继发性骨质疏松症的诊疗新进展OA

Renal tubular acidosis(RTA)is a clinical syndrome characterized by impaired renal acidification function,and the resulting chronic metabolic acidosis is an important risk factor for the development and progression of os-teoporosis.At present,the pathophysiological mechanisms underlying RTA-associated secondary osteoporosis have not been fully elucidated,and its clinical diagnostic and therapeutic strategies still require further optimization.This review systematically summarizes the pathophysiological mechanisms by which different types of RTA contribute to osteoporosis,including the complex effects of chronic metabolic acidosis on bone mineral homeostasis,osteoblast and osteoclast func-tion,and skeletal metabolism.The clinical characteristics of RTA-associated osteoporosis are also discussed.Further-more,this article reviews current therapeutic strategies targeting RTA itself,including alkali supplementation therapy,cor-rection of electrolyte disturbances,and the application of glucocorticoids and immunosuppressive agents,as well as their potential effects on osteoporosis.This review aims to provide an important theoretical basis and practical guidance for the clinical recognition and management of this special type of metabolic bone disease.