Related Experiment Video

Updated: Jul 4, 2026

5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats
05:34

5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats

Published on: April 4, 2025

Treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD)

Hirotaka Komaba1, Motoko Tanaka, Masafumi Fukagawa

  • 1Division of Nephrology and Kidney Center, Kobe University School of Medicine, Kobe.

Internal Medicine (Tokyo, Japan)
|June 4, 2008
PubMed

Insights

Chronic kidney disease (CKD) mineral and bone disorder (CKD-MBD) management is evolving. New therapies aim to improve survival and reduce complications in dialysis patients with CKD-MBD.

Area of Science:

  • Nephrology
  • Endocrinology
  • Cardiovascular Medicine

Background:

  • Mineral and bone metabolism disturbances are key in cardiovascular complications of chronic kidney disease (CKD).
  • CKD-mineral and bone disorder (CKD-MBD) now encompasses vascular calcification and bone abnormalities, replacing "renal osteodystrophy."
  • Japanese guidelines prioritize survival over bone health in dialysis patients with secondary hyperparathyroidism.

Purpose of the Study:

  • To review the paradigm shift in understanding CKD-MBD.
  • To discuss the updated guidelines for managing secondary hyperparathyroidism in chronic dialysis patients.
  • To highlight novel therapeutic tools for CKD-MBD management in Japan.

Main Methods:

  • Literature review of CKD-MBD pathogenesis and management.
  • Analysis of Japanese Society for Dialysis Therapy guidelines.
  • Overview of recently introduced therapeutic agents.

Main Results:

  • CKD-MBD is a comprehensive term including vascular and bone issues.
  • Guidelines suggest parathyroid intervention if pharmacological management fails.
  • New agents like sevelamer hydrochloride, calcitriol analogs, and cinacalcet hydrochloride are available.

Conclusions:

  • Effective management of CKD-MBD requires harmonizing various therapeutic modalities.
  • Improved CKD-MBD management is expected to reduce morbidity and mortality in dialysis patients.
  • Integration of new therapies holds promise for better patient outcomes.

Related Concept Videos

Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
Chronic Kidney Disease IV: Nursing Management01:18

Chronic Kidney Disease IV: Nursing Management

Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of fluid...
Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration01:28

Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration

Glomerular filtration rate (GFR) can be estimated from serum creatinine using the modification of diet in renal disease (MDRD) formula or the chronic kidney disease–epidemiology collaboration (CKD–EPI) equation. Both methods are widely used in clinical practice to assess kidney function and guide treatment decisions.The MDRD equation does not require weight or height measurements and is normalized to the body surface area of 1.73 m², considered the average adult surface area. This equation is...