[Mineral and bone disturbances associated with chronic kidney disease]

Area of Science:

• Nephrology
• Endocrinology
• Pathology

Background:

• Chronic kidney disease (CKD) is associated with significant disturbances in mineral and bone metabolism.
• These disturbances, along with extra-skeletal calcification, intensify in later stages of CKD.
• CKD-associated mineral and bone disorders (CKD-MBD) contribute to reduced quality of life, disability, and cardiovascular mortality.

Purpose of the Study:

• To review the concept and manifestations of chronic kidney disease-mineral and bone disorders (CKD-MBD).
• To highlight the shift from the term Renal Osteodystrophy to CKD-MBD, reflecting broader pathological involvement.
• To emphasize the clinical significance of CKD-MBD in patient outcomes.

Main Methods:

• Review of existing literature and clinical guidelines.
• Analysis of diagnostic criteria for CKD-MBD.
• Synthesis of information regarding the pathophysiology and clinical impact of CKD-MBD.

Main Results:

• CKD-MBD encompasses biochemical abnormalities (serum calcium, phosphate, PTH, vitamin D), bone changes (metabolism, mineralization, volume), and soft tissue/vascular calcification.
• The term CKD-MBD accurately reflects that these disorders affect systems beyond the skeleton.
• These complications are prevalent and significantly impact cardiovascular morbidity and mortality in CKD patients.

Conclusions:

• CKD-MBD represents a complex interplay of metabolic and structural changes.
• Early recognition and management of CKD-MBD are crucial for improving patient prognosis.
• The comprehensive understanding of CKD-MBD is essential for effective patient care and reducing cardiovascular risks.