Mineral Bone Disorders in Kidney Disease Patients: The Ever-Current Topic

Chronic kidney disease (CKD) is a complex and multifactorial disease, and one of the most prevalent worldwide. Chronic kidney disease-mineral bone disorders (CKD-MBD) with biochemical and hormonal alterations are part of the complications associated with the progression of CKD. Pathophysiology of CKD-MBD focused on abnormalities in serum levels of several biomarkers (such as FGF-23, klotho, phosphate, calcium, vitamin D, and PTH) which are discussed in this review. We therefore examine the prognostic association between CKD-MBD and the increased risk for cardiovascular events, mortality, and CKD progression to end-stage kidney disease (ESKD). Lastly, we present specific treatments acting on CKD to prevent and treat the complications associated with secondary hyperparathyroidism (SHPT): control of hyperphosphatemia (with dietary restriction, intestinal phosphate binders, and adequate dialysis), the use of calcimimetic agents, vitamin D, and analogues, and the use of bisphosphonates or denosumab in patients with osteoporosis.

Automated summary

Chronic kidney disease (CKD) is a prevalent and complex disease, and chronic kidney disease-mineral bone disorders (CKD-MBD) are complications associated with the progression of CKD. This review focuses on the abnormalities in serum levels of various biomarkers in CKD-MBD and examines the prognostic association between CKD-MBD and the increased risk for cardiovascular events, mortality, and CKD progression. Specific treatments for CKD-MBD are also presented.