Mineral Bone Disorders in Kidney Disease Patients: The Ever-Current Topic

Int J Mol Sci. 2022 Oct 13;23(20):12223. doi: 10.3390/ijms232012223.

Abstract

Chronic kidney disease (CKD) is a complex and multifactorial disease, and one of the most prevalent worldwide. Chronic kidney disease-mineral bone disorders (CKD-MBD) with biochemical and hormonal alterations are part of the complications associated with the progression of CKD. Pathophysiology of CKD-MBD focused on abnormalities in serum levels of several biomarkers (such as FGF-23, klotho, phosphate, calcium, vitamin D, and PTH) which are discussed in this review. We therefore examine the prognostic association between CKD-MBD and the increased risk for cardiovascular events, mortality, and CKD progression to end-stage kidney disease (ESKD). Lastly, we present specific treatments acting on CKD to prevent and treat the complications associated with secondary hyperparathyroidism (SHPT): control of hyperphosphatemia (with dietary restriction, intestinal phosphate binders, and adequate dialysis), the use of calcimimetic agents, vitamin D, and analogues, and the use of bisphosphonates or denosumab in patients with osteoporosis.

Keywords: CKD–MBD; ESKD; cardiovascular; epidemiology; kidney; prognosis.

Publication types

  • Review

MeSH terms

  • Biomarkers
  • Bone Diseases* / complications
  • Calcimimetic Agents
  • Calcium
  • Chronic Kidney Disease-Mineral and Bone Disorder* / complications
  • Denosumab
  • Diphosphonates
  • Humans
  • Minerals
  • Parathyroid Hormone
  • Phosphates
  • Renal Dialysis
  • Renal Insufficiency, Chronic* / therapy
  • Vitamin D / therapeutic use
  • Vitamins

Substances

  • Calcimimetic Agents
  • Calcium
  • Denosumab
  • Vitamin D
  • Phosphates
  • Minerals
  • Vitamins
  • Biomarkers
  • Diphosphonates
  • Parathyroid Hormone

Grants and funding

This research received no external funding.