Improving global outcomes in mineral and bone disorders

Area of Science:

• Nephrology
• Endocrinology
• Bone Metabolism

Background:

• Mineral and bone metabolism disturbances are common in chronic kidney disease (CKD).
• These disturbances contribute to morbidity, reduced quality of life, extraskeletal calcification, and increased cardiovascular mortality.
• The Kidney Disease: Improving Global Outcomes (KDIGO) Global Mineral and Bone Initiative aims to refine understanding and management of these complications.

Purpose of the Study:

• To update the definition, evaluation, and classification of CKD-mineral and bone disorder (CKD-MBD).
• To improve standardization of assessment tools and enhance education regarding CKD-MBD.
• To stimulate research and foster international consensus on terminology.

Main Methods:

• A 2005 Controversies Conference was convened to better define CKD-MBD complications.
• Recommendations were established for distinct terminology: 'renal osteodystrophy' for bone morphology changes and 'CKD-MBD' for the broader clinical syndrome.
• The multifaceted nature of CKD-MBD was defined, encompassing laboratory, bone, and calcification abnormalities.

Main Results:

• Recommended exclusive use of 'renal osteodystrophy' for CKD-associated bone morphology alterations.
• Recommended 'chronic kidney disease-mineral and bone disorder' (CKD-MBD) for the systemic syndrome.
• Defined CKD-MBD manifestations including abnormal calcium, phosphorus, parathyroid hormone, vitamin D metabolism, bone changes (turnover, mineralization, volume, growth, strength), and vascular/soft tissue calcification.

Conclusions:

• Adoption of common, internationally accepted terminology is crucial.
• Standardized terminology will facilitate comparison of research studies.
• Improved terminology is expected to enhance patient care globally for individuals with CKD-MBD.