Pathophysiology and treatment of chronic kidney disease-mineral and bone disorder

Mark R. Hanudel, Sharon Moe, Isidro B. Salusky

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

The kidney plays an important role in bone and mineral homeostasis, regulating calcium, phosphate, PTH, fibroblast growth factor 23 (FGF23), and calcitriol metabolism. The pathophysiology of calcification in chronic kidney disease (CKD) patients clearly differs from that observed in the general population, although the mechanisms by which vascular calcification develop remain to be fully elucidated. CKD-mineral and bone disorder (CKD-MBD) pathogenesis involves a complex interplay among the kidney, bone, and parathyroid glands. Different factors have been implicated in the pathogenesis of this maladaptive response, but the primary trigger remains to be defined. Therapeutic approaches in CKD-MBD focus primarily on treating hyperphosphatemia and lowering elevated PTH levels. The goal of therapy is that optimization of these parameters limits the contribution of CKD-MBD to adverse CKD-associated outcomes, including fractures, CKD progression, and cardiovascular morbidity and mortality. Therefore, optimizing CKD-MBD treatment paradigms may improve clinical outcomes and life expectancy in the CKD population.

Original languageEnglish (US)
Title of host publicationPrimer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism
Publisherwiley
Pages695-704
Number of pages10
ISBN (Electronic)9781119266594
ISBN (Print)9781119266563
DOIs
StatePublished - Jan 1 2018

Keywords

  • Chronic kidney disease
  • Mineral and bone disorder
  • Pathogenesis
  • Pathophysiology
  • Therapeutic approaches
  • Treatment paradigms

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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  • Cite this

    Hanudel, M. R., Moe, S., & Salusky, I. B. (2018). Pathophysiology and treatment of chronic kidney disease-mineral and bone disorder. In Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism (pp. 695-704). wiley. https://doi.org/10.1002/9781119266594.ch90