[Renal osteodystrophy: diagnostic-therapeutic approach]

Disturbances in mineral and bone metabolism are common in patients with chronic kidney disease (CKD). Patients with CKD almost always develop secondary hyperplasia of the parathyroid glands, resulting in elevated blood levels of parathyroid hormone (PTH). The processes causing disordered mineral metabolism and bone disease have their onset in the early stages of CKD, continue throughout the course of progressive loss of kidney function and may be influenced beneficially or adversely by various therapeutic approaches used. It is should be emphasized that the care of CKD patients with bone disease requires frequent assessment of the various parameters (levels of calcium, phosphorus, vitamin D, PTH) and frequent evaluation of the therapies.