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目的:调查和分析慢性肾脏病(chronic kidney disease, CKD)G3～G5期患者矿物质及骨代谢异常(mineral and bone disorder, MBD)状况，为CKD-MBD的早期诊治提供临床参考。方法:对2014年8月至2019年8月期间于我院接受治疗的323例CKD G3～G5期非透析患者的矿物质及骨代谢相关指标(血清钙、磷、全段甲状旁腺激素、碱性磷酸酶等)进行回顾性分析。将入选患者分成CKD G3期组、CKD G4期组、CKD G5期组，比较各组间矿物质及骨代谢相关指标的差异，评估各组间低钙血症、高磷血症及高甲状旁腺激素水平的发生率。结果:CKD G3、G4、G5期患者血磷浓度分别为(1.28±0.25)、(1.48±0.30)和(2.03±0.62)mmol/L(n F＝ 81.51，n P<0.01)，高磷血症的发生率分别为25.56%、47.95%和83.75%。校正血钙浓度分别为(2.34±0.11)、(2.26±0.17)和(2.07±0.27)mmol/L(n F＝51.45，n P<0.01)，低钙血症的发生率分别为2.22%、9.59%和41.25%。全段甲状旁腺素浓度分别为(90.82±55.59)、(161.63± 143.55)和(282.02±162.04)ng/L(n F＝60.83，n P<0.01)，高甲状旁腺激素的发生率分别为56.67%、68.49%和38.13%。相关分析结果显示，全段甲状旁腺激素水平与血磷(n r＝0.32，n P<0.01)呈正相关，与肾小球滤过率(n r＝-0.52，n P<0.01)、校正血钙(n r＝-0.43，n P<0.01)呈负相关。n 结论:CKD G3期后随着肾小球滤过率的进行性下降，患者血磷、全段甲状旁腺激素逐渐升高，血钙逐渐降低。为更好地改善CKD患者的预后，提高患者生存质量，应加强对非透析中、晚期CKD患者的MBD进行早期监测及临床干预。“,”Objective:To investigate the mineral and bone disorder (MBD) in patients with chronic kidney disease (CKD ) at stage G3 to G5.Methods:A cross-sectional study was carried out in the Ninetl People’s Hospital of Suzhou. From August 2014 to August 2019, 323 inpatients were enrolled. Parameters including serum phosphorus (P), total calcium (t-Ca), intact parathyroid hormone (iPTH) and alkaline phosphatase (AKP) were analyzed. All the patients were divided into three groups (CKD G3 group, CKD G4 group and CKD G5 group ). The parameters of MBD were compared and the abnormal conditions of calcium, phosphorus and iPTH were evaluated.Results:In CKD G3 to G5 patients, serum P was(1.28±0.25), (1.48±0.30) and (2.03±0.62 )mmol/L (n F=81.51, n P<0.01); the incidence of hyperphosphatemia was 25.56%, 47.95% and 83.75%; serum Ca was(2.34±0.11), (2.26±0.17), and (2.07±0.27)mmol/L (n F=51.45, n P<0.01); the incidence of hypocalcemia was 2.22%, 9.59% and 41.25%; serum iPTH was(90.82±55.59), (161.63±143.55) and (282.02±162.04)ng/L (n F=60.83, n P<0.01); the incidence of high parathyroid hormone was 56.67%, 68.49% and 38.13%, respectively. Correlation analysis showed that serum iPTH level was positively correlated with serum phosphate (n r=0.32, n P<0.01) and negatively correlated with serum calcium (n r=-0.43, n P<0.01) and glomerular filtration rate (GFR ) (n r=-0.52, n P<0.01).n Conclusions:From the beginning of the CKD G3 stage, serum Ca, P, iPTH began to appear relatively abnormal, and with the progressive decrease of glomerular filtration rate, serum P and iPTH began to gradually increase, and serum Ca gradually decreased. Early monitoring and clinical intervention should be given to improve patients’ outcomes.