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Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD): Current Perspectives

Bala Waziri1,2, Raquel Duarte1, Saraladevi Naicker1

  • 1Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

International Journal of Nephrology and Renovascular Disease
|January 11, 2020
PubMed

Insights

Chronic kidney disease-mineral and bone disorder (CKD-MBD) affects many patients despite guidelines. Recent advances, including fibroblast growth factor 23 (FGF23) and updated KDIGO recommendations, are improving CKD-MBD management.

Area of Science:

  • Nephrology
  • Endocrinology
  • Biochemistry

Background:

  • Chronic kidney disease-mineral and bone disorder (CKD-MBD) remains prevalent despite existing guidelines.
  • Adverse clinical outcomes persist in CKD patients due to CKD-MBD.
  • Continuous research aims to enhance the understanding and management of CKD-MBD.

Purpose of the Study:

  • To provide an overview of the evolving trends in CKD-MBD.
  • To connect historical and contemporary concepts of CKD-MBD.
  • To highlight recent advancements in CKD-MBD research and clinical practice.

Main Methods:

  • Review of scientific literature and clinical trial data.
  • Analysis of the impact of fibroblast growth factor 23 (FGF23) on CKD-MBD pathogenesis.
  • Examination of shifts in diagnostic and therapeutic approaches for CKD-MBD.

Main Results:

  • Discovery of fibroblast growth factor 23 (FGF23)'s role, updating the trade-off hypothesis.
  • Transition from single biomarker measurements to serial monitoring of calcium, phosphate, and parathyroid hormone (PTH).
  • Emergence of new clinical trials leading to updated Kidney Disease-Improving Global Outcomes (KDIGO) guidelines in 2017.

Conclusions:

  • CKD-MBD management has significantly evolved.
  • Understanding of CKD-MBD pathogenesis has advanced with new discoveries like FGF23.
  • Updated guidelines and monitoring strategies offer improved clinical care for CKD-MBD patients.

Keywords:
chronic kidney disease–mineral and bone disorderemerging trendsmanagementupdated pathogenesis

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