[Parathyroid and bone. Mineral and bone disorder and parathyroid function in chronic kidney disease]

In chronic kidney disease (CKD), mineral and hormonal abnormality is observed at an early stage, followed by bone disorder and vascular calcification, consequently leading to decreased survival. Thus, an idea of systemic disorder, CKD-mineral and bone disorder (CKD-MBD) has been currently advocated, and its management has been discussed aiming at longevity. Low serum vitamin D level, accumulation of phosphorus and uremic toxins, increased oxidative stress, and secondary hyperparathyroidism play central roles in the pathogenesis of CKD-MBD. Recent findings suggest that active management for CKD-MBD could improve mortality as well as kidney prognosis.